How many parameters variables are assessed in a biophysical profile BPP )?

Biophysical profile
How many parameters variables are assessed in a biophysical profile BPP )?
SynonymsBPP
Purposeprenatal evaluation ultrasound

A biophysical profile (BPP) 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 (NST) is non reactive, or for other obstetrical indications.

The "modified biophysical profile" consists of the NST and amniotic fluid index only.

Procedure[edit]

The BPP has 5 components: 4 ultrasound (US) assessments and an NST. The NST evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables:

  1. Fetal heart rate
  2. Fetal breathing
  3. Fetal movement
  4. Fetal tone
  5. Amniotic fluid volume
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 or >20s[3] in 30 minutes None or less than 30s or 20s[3]
US: Fetal activity / gross body movements At least three discrete body/limb movement in 30 minutes (episodes of active continuous movement considered a single movement. Less than three or two[3] movements
US: Fetal muscle tone At least one[3] episode of active extension with return to flexion of fetal limb(s) or trunk, opening and closing of hand considered to be normal tone. Either slow extension with return to partial flexion or movement of limb in full extension or absent fetal movement.
US: Qualitative AFV/AFI At least one vertical pocket > 2 cm in the vertical axis or AFI of 5 cm Largest vertical pocket </= 2 cm, or AFI </= 5 cm

Use of vibroacoustic stimulation to accelerate evaluation has been described.[4]

Interpretation[edit]

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 movements do not occur in the first half[citation needed]. 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.

Recommended management based on the biophysical profile[5]
BPPRecommended management
≤2
  • Labor induction
4
  • Labor induction if gestational age >32 weeks
  • Repeating test same day if <32 weeks, then delivery if BPP <6
6
  • Labor induction if >36 weeks if favorable cervix and normal AFI
  • Repeating test in 24 hours if <36 weeks and cervix unfavorable; then delivery if BPP <6, and follow-up if >6
≥ 8
  • Labor induction if presence of oligohydramnios

See also[edit]

  • Nonstress test
  • Cardiotocography

References[edit]

  1. ^ Lalor, J. G.; Fawole, B.; Alfirevic, Z.; Devane, D. (2008-01-23). "Biophysical profile for fetal assessment in high risk pregnancies". The Cochrane Database of Systematic Reviews (1): CD000038. doi:10.1002/14651858.CD000038.pub2. ISSN 1469-493X. PMC 7052779. PMID 18253968.
  2. ^ 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. ^ a b c d "Biophysical Profile, Ultrasound: eMedicine Radiology". Retrieved 2009-12-29.
  4. ^ 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. S2CID 32503466.
  5. ^ 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. [1] "Archived copy" (PDF). Archived from the original (PDF) on 2013-05-13. Retrieved 2012-08-02.{{cite web}}: CS1 maint: archived copy as title (link)

How many parameters should a biophysical profile have?

The fetal biophysical profile (BPP) is a noninvasive, easily learned and performed antepartum test for evaluating fetal well-being. Ultrasound is used to assess four discrete biophysical parameters: fetal movement, fetal tone, fetal breathing, and amniotic fluid volume.

What are the 5 parameters of the biophysical profile?

During the biophysical profile, your provider is looking at 5 main areas to check your baby's health: body movements, muscle tone, breathing movements, amniotic fluid, and heartbeat. Each of these 5 areas is given a score of either 0 (abnormal) or 2 (normal).

What items are assessed in a biophysical profile?

A biophysical profile (BPP) includes ultrasound monitoring of fetal movements, fetal tone and fetal breathing, ultrasound assessment of liquor volume with or without assessment of the fetal heart rate.

How many parameters are to be considered in the biophysical profile and what is the highest potential score for each parameter?

The BPP tests four parameters over a 30-minute observation period. The fetus receives a score of zero or two points for each parameter, and the sum is the BPP score. A score of 6/8 or 8/8 is normal. Most fetuses that score ≤ 6/8 need additional monitoring.