Biophysical profile
A biophysical profile is a prenatal ultrasound evaluation of fetal well-being involving a scoring system,[1] with the score being termed Manning's score.[2] It is often done when a non-stress test is non reactive, or for other obstetrical indications.
The "modified biophysical profile" consists of the nonstress test and amniotic fluid index only.
Procedure
The biophysical profile (BPP) has 5 components: 4 ultrasound (US) assessments and a nonstress test (NST). The nonstress test (NST)(CTG) evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables:
- Fetal movement
- Fetal tone
- Fetal breathing
- Amniotic fluid volume
- Fetal Heart Rate
| Parameter | Normal (2 points) | Abnormal (0 points) |
|---|---|---|
| NST/Reactive FHR | At least two accelerations in 20 minutes | Less than two accelerations to satisfy the test in 20 minutes |
| US: Fetal breathing movements | At least one episode of > 30s[citation needed] or >20s[3] in 30 minutes | None or less than 30s[citation needed] or 20s[3] |
| US: Fetal activity / gross body movements | At least three[citation needed] or two[3] movements of the torso or limbs | Less than three[citation needed] or two[3] movements |
| US: Fetal muscle tone | At least one[3] episodes of active bending and straightening of the limb or trunk | No movements or movements slow and incomplete |
| US: Qualitative AFV/AFI | At least one vertical pocket> 2 cm or more in the vertical axis | Largest vertical pocket</=2 cm |
Use of vibroacoustic stimulation to accelerate evaluation has been described.[4]
Interpretation
Each assessment is graded either 0 or 2 points, and then added up to yield a number between 0 and 10. A BPP of 8 or 10 is generally considered reassuring. A BPP normally is not performed before the second half of a pregnancy, since fetal breathing movements do not occur in the first half.
The presence of these biophysical variables implies absence of significant central nervous system hypoxemia/acidemia at the time of testing. By comparison, a compromised fetus typically exhibits loss of accelerations of the fetal heart rate (FHR), decreased body movement and breathing, hypotonia, and, less acutely, decreased amniotic fluid volume.
| BPP | Recommended management |
|---|---|
| ≤2 | |
| 4 |
|- ! 6 | *Labor induction if >36 weeks if favorable cervix and normal AFI
|
| 8 |
|
References
- ↑ Alfirevic Z, Neilson JP (2000). "Biophysical profile for fetal assessment in high risk pregnancies". In Alfirevic, Zarko. Cochrane Database Syst Rev (2): CD000038. doi:10.1002/14651858.CD000038. PMID 10796097.
- ↑ Page 215, Chapter 39 on Biophysical Profile (BPP), in: Title: Diagnostic Ultrasound, Volume: 2, Issue: 1 of The Veterinary clinics of North America. Equine practice, Author: Norman W. Rantanen. Publisher: Jaypee Brothers Publishers, 1986. ISBN 9788184480641. Length: 261 pages
- ↑ 3.0 3.1 3.2 3.3 3.4 "Biophysical Profile, Ultrasound: eMedicine Radiology". Retrieved 2009-12-29.
- ↑ Pinette MG, Blackstone J, Wax JR, Cartin A (June 2005). "Using fetal acoustic stimulation to shorten the biophysical profile". J Clin Ultrasound 33 (5): 223–5. doi:10.1002/jcu.20116. PMID 16047387.
- ↑ Intrauterine Growth Retardation. ROBERT C. VANDENBOSCHE, M.D., and JEFFREY T. KIRCHNER, D.O., Lancaster General Hospital, Lancaster, Pennsylvania. Am Fam Physician. 1998 Oct 15;58(6):1384-1390.
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