In the third trimester of pregnancy, your provider may ask you to have a biophysical profile test (BPP) to assess the baby’s health when certain conditions occur. This test is used as a noninvasive method of diagnosing and evaluating the baby’s health. The results of the in-office biophysical profile ultrasound can show you the movement of the baby, the progress of muscle development, heart rate, breathing pattern, and the level of amniotic fluid, which is all critical information for your chosen medical provider. 

There is a possibility that the patient might have to repeat the BPP ultrasound multiple times, but this is done under the direct supervision of your chosen doctor. In order to pick the doctor that’s best suited for your particular situation and health status, you need to do more thorough research, and clinics such as Women’s Health Partners are there to make the search easier due to many different experts in their professional team. 

What Is a Fetal Biophysical Profile?

Smiling Pregnant Woman Patient Talking With Doctor During Appointment Sitting in Modern Clinic Office.

As mentioned, a BPP is a test that is performed to evaluate the health of the fetus. Most often, it is done when the doctors deem the pregnancy high-risk due to certain health conditions of the mother or the baby. This type of test helps the medical provider give you advice and guidance on how to preserve your pregnancy and the baby’s health as well as possible. 

A biophysical profile score is obtained through an ultrasound procedure where the doctor looks at four areas (plus the fetal heart rate via a nonstress test) and combines the results to create a fetal biophysical profile. This is a very low-risk procedure, minimally invasive, with important results. 

The following areas are looked at during a BPP ultrasound:

  • The muscle tone of the fetus is measured when it opens and closes its hands or extends the arms and legs.
  • Body movement is looked at through the movement of limbs or the whole body. 
  • Amniotic fluid levels are measured through a pocket of amniotic fluid, which should be at least one centimeter wide and two centimeters long.
  • Breathing movements are deemed healthy if the fetus has a rhythmic, continuous breathing pattern. 

Sometimes your doctor does only a partial or modified BPP instead of a complete one where they combine the nonstress test (to measure the heart rate) together with the measurement of amniotic fluid levels. 

 Reasoning Behind a BPP 

You might wonder what the situations in which you will be advised to do a biophysical profile test are, so below is a list of health conditions and issues that might condition you to undergo this type of ultrasound:

  • High-risk pregnancy
  • Pregnancy longer than 40 weeks 
  • Lupus
  • Hypertension
  • Decrease in the fetal movement
  • Carrying multiple babies
  • Previous experiences of stillbirth or miscarriage 
  • High blood pressure 
  • Preeclampsia 
  • Intrauterine fetal growth restrictions
  • Diabetes 
  • Low or high amniotic fluid levels
  • The patient is older than 35 years of age
  • The patient is obese (BMI higher than 30)
  • Kidney disease 
  • Severe asthma cases 

BPP Pregnancy Test Preparation and Procedure

Depressed Pregnant Woman Consultation With Psychologist

As the test is noninvasive, it does not require a lot of preparation. You might be advised to eat before the test, to make the baby more active, as well as to empty your bladder to feel more comfortable during the procedure.

The BPP test does not last longer than 40 minutes, and most often it is performed in your medical provider’s office. It looks like this:

  • Ultrasound exam: The patient lies down on the exam table, uncovering the abdomen and the doctor uses a gel and probe to get an image of the wanted area. The transducer produces sound waves and converts them into images, which can be viewed on a screen by both the patient and the doctor.
  • Nonstress test: When needed, a NST is done, to monitor the baby’s heart rate. With an electronic fetal monitor, the medical provider measures the heartbeat of the child. The fetal heart rate should beat faster during movement, so if the device does not record at least two increases during the test, this means that the baby is asleep and needs to be woken up. This test usually takes around 20 minutes.

When it comes to the biophysical profile score, the scoring system is quite simple. The results of all areas are added up, and the score is placed between zero and ten. When the results show a score of eight or more, that means the functioning and development of the fetus are normal. A score lower than eight might be indicative of a health issue, so you will probably need to do some additional exams and tests. 

Here is some more practical information about BPP scores:

  • Each activity can get a maximum of two points and a minimum of zero. 
  • The fetal body movement gets two points if the baby does three or more movements within 30 minutes.
  • Muscle tone is considered normal if there are one or more episodes of active extension and flexion of a leg or an arm in 30 minutes.
  • If the fetus has at least one continuous episode of breathing that lasts at least 30 seconds, it is considered normal. 
  • If one pocket of amniotic fluid has one centimeter across and two vertically, the score would be two points. 

If the results are below the score of eight, do not panic. There are different factors that can influence the score, so make sure you discuss all of this with your chosen doctor to deal with any unnecessary worry and stress promptly. 

The results most often come on the day of your test, and you will have to schedule an appointment with your doctor to discuss the biophysical profile score and the next steps if the results are not satisfactory. 

When it comes to potential risks or disadvantages of the procedure, they may include the following:

  • The test is unreliable if done before the 28th week of pregnancy.
  • If the patient is taking corticosteroids, the breathing pattern of the fetus might be affected, and the test results can be negative.
  • The test sometimes must be repeated. 

A biophysical profile is a very safe test, which does not harm your child, and it lets your doctor monitor the development and health of the fetus, so you do not have to worry if the doctor suggests it to you as part of your pregnancy care process. 

Contact Us!

The BPP pregnancy test is one of the many tests our clinic offers to our patients. Our high-quality equipment and experienced staff are there to welcome you and deliver the best service possible. Call our clinic if you have any questions or concerns or if you simply want to check what your options are when it comes to monitoring the health of your future child. Pregnancy is a stressful period in your life, and we are here to help you feel as comfortable and relaxed as possible.

Your and your child’s health is our top priority, so get in touch today and find out why we are one of the best in this field!