What Is a Biophysical Profile?

A BPP may sound like an extensive, complex test. But in fact, it’s actually a noninvasive test that doctors use to evaluate fetal movement, breathing, heart rate, amniotic fluid, and muscle tone.

This test combines a fetal ultrasound with fetal heart rate monitoring (nonstress test). A nonstress test is another test conducted during pregnancy, typically after 28 weeks.

Doctors often recommend this test for high risk pregnancies or if you’re past your due date. It basically tracks a baby’s heartbeat when they go from resting to moving, which helps doctors assess whether the baby is getting enough oxygen.

Ultrasound monitoring, which also monitors fetal movements, helps your doctor evaluate your baby’s growth and development, too.

Preparing for the test

The test is relatively short and you don’t have to make any special preparations. Your doctor may schedule the test in their office or at the hospital, and it usually takes about 30 minutes.

During the test

It’s a two-part test. During the nonstress portion, your doctor will place a special belt around your stomach. Then you’ll lie down and get comfortable (as comfortable as possible) on the examination table.

As you’re lying on the table, the belt around your stomach measures your baby’s heart rate during movement. Keep in mind, some babies are asleep and not very active during this test. If so, your doctor will attempt to wake up your baby, sometimes by making a noise near your stomach. If this doesn’t work, they may have you drink or eat something, as this usually wakes up a fetus.

If your baby doesn’t wake up, your doctor may reschedule testing in order to receive more accurate results.

During the second part of the test — the ultrasound — you’ll also lie on an examination table. But this time, an ultrasound technician places a special gel over your stomach. The technician then moves a device over your stomach, which creates an image of your baby.

From here, the technician can check your baby’s movements, breathing, amniotic fluid, and muscle tone.

Your doctor will likely request a biophysical profile if you’re at a higher risk for complications or pregnancy loss.

Since this test monitors your baby’s health, the results can help doctors determine whether you’ll need to deliver early to avoid pregnancy loss. According to the Mayo Clinic, your doctor may recommend a biophysical profile if you:

• have a history of pregnancy complications
• have high blood pressure, diabetes, or heart disease
• are at least 2 weeks past your due date
• have a history of pregnancy loss
• have abnormal amniotic fluid levels
• have obesity (BMI greater than 30)
• are older than 35
• are carrying multiples
• are Rh negative

Decreased fetal movement is another reason why your doctor might order a biophysical test.

A BPP takes place later in the pregnancy, typically after weeks 24 or 32. If you’re at a higher risk for pregnancy loss, your doctor might schedule a biophysical profile every week (starting in the third trimester) up until you deliver the baby.

This allows your doctor to keep a close eye on your baby’s health, and then deliver early, if necessary.

Whenever you’re scheduled a medical test during pregnancy, you might approach the test with a little apprehension. This is normal, especially if it’s your first pregnancy and you don’t know what to expect. But biophysical profiles aren’t dangerous and don’t pose any risks to you or your baby

One good thing about a biophysical profile is that you don’t have to wait days or weeks for the results.

Typically, doctors discuss scores immediately after the test. Each area evaluated receives a score ranging from zero to two points — two points if results are normal, and zero points if results aren’t normal.

Ideally, you want a final score between 8 and 10 points, as this indicates that your baby is healthy. If you score between six and eight points, your doctor may re-test within the next 24 hours.

A score of four points or less could indicate a problem with your pregnancy, and your doctor may need to conduct further testing to better gauge your baby’s health. Here is the criteria for scoring:

Heartbeat

For the nonstress portion of the test, if your baby’s heartbeat increases with movement (at least 15 beats per minutes) on at least two occasions — you’ll receive two points. If movement doesn’t increase your baby’s heartbeat by this much, you’ll receive zero points.

Breathing

With regard to fetal breathing, your baby must have at least one episode of fetal breathing lasting at least 30 seconds in 30 minutes to receive two points.

Movement

Your baby must move at least three times within 30 minutes to receive two points.

Muscle tone

Interestingly, the test also looks at fetal muscle tone, and gives two points if your baby is able to move an arm or leg from a bent position to an extended position within 30 minutes. You’ll receive zero points if your baby doesn’t change position within this time frame.

Amniotic fluid

You’ll also receive two points if the deepest pocket of amniotic fluid measures more than 2 centimeters. If you don’t meet this criteria, you’ll receive zero points.

Don’t immediately panic if you have an abnormal biophysical profile result. This doesn’t necessarily mean that there’s a problem with your pregnancy. Different factors can affect your results, such as:

• having an infection
• taking certain medications
• having low blood sugar
• being overweight

Also, your baby’s position could have made it hard to complete the ultrasound. Either way, if you score low, your doctor will re-test in about 12 to 24 hours.

A biophysical profile is one of many tests that you’ll likely have during pregnancy. The good news, though, is that it’s a noninvasive test that’s completed within a relatively short time.

It’s normal to feel some anxiety before an ultrasound or other tests. But try to stay calm. This is a safe test that doesn’t pose any type of risk to you or your baby.