The fetal biophysical profile (BPP) is a non-invasive method that can be performed, with your doctor’s consent, from the 28th week of pregnancy. Its purpose is to assess the life of the fetus using indicators and parameters, such as indication of gestational age, growth and monitoring of the baby’s movements, as well as breathing, heartbeats, well-being, and the volume of amniotic fluid.
The biophysical profile analysis procedure uses some parameters assessed in the ultrasound, with the differential being the combination of ultrasonography with another fetal life analysis procedure, cardiotocography (CTG). Ultrasonography or sonography is popularly recognized as an essential tool for monitoring pregnancy.
Cardiotocography or “fetal monitoring” is a procedure characterized by the graphic recording of uterine contractions and the baby’s heartbeats. This exam allows, if any problems are detected, for timely intervention procedures to be performed while the baby is still in the womb.
In What Cases Is the Fetal Biophysical Profile Requested?
The exam is recommended for pregnant women who fall into the profile of high-risk pregnancy: when the baby appears smaller than ideal for gestational age, or when the mother develops gestational diabetes, low levels of amniotic fluid, high blood pressure, and/or pre-eclampsia. However, some doctors request the fetal biophysical profile even when the pregnant woman is not in the risk group, aiming to ensure a successful pregnancy.
What Is Evaluated?
The analysis of the fetal biophysical profile is done by evaluating five variables:
- Fetal body movement
- Fetal breathing movement
- Fetal tone
- Volume of Amniotic Fluid
- Cardiotocography
Each variable receives a score of 2 (two) or 0 (zero), where the higher score (two) indicates normality of the evaluated variable, while the lower score (zero) indicates abnormality. The interpretation of the fetal biophysical profile will be done according to the score, i.e., the sum of the variables, ranging from 0 to 10. See how the scoring is calculated:
| Score | Diagnosis |
|---|---|
| 8-10 | Normal Newborn |
| 6 | Suspected Chronic Asphyxia |
| 4 | Chronic Asphyxia |
| 0-2 | Strong Suspicion of Asphyxia |
The fetus will be considered healthy when the total score is equal to or greater than 6 (six), which represents a low risk of acute and chronic asphyxia. A score below this value indicates that the fetus is experiencing complications. Tests showing abnormalities indicate a 50 to 100 times higher chance of fetal death.
It is important, by comparison, to pay attention to the possibility the test indicates a false positive (in cases with a score below six). The results of the Fetal Biophysical Profile evaluation should be analyzed together with the mother’s conditions, as these may be temporary and correctable.
Preparation and Guidelines for Fetal Biophysical Profile Exams
The two procedures used as the basis for calculating the fetal biophysical profile are simple and non-invasive.
In sonography, also known as ultrasound, a device emits sound waves that penetrate the skin of the abdomen and form echoes, from which images of inside the uterus are generated.
In fetal monitoring, called cardiotocography, some sensors are placed on fabric straps around the abdomen of the woman lying down, so that the baby’s heartbeat and uterine contractions can be measured. In addition, there will be a small transmitter in the mother’s hand to be pressed each time she feels the baby move.
All of this will be recorded on a monitor and doctors, using software that produces a reactive or non-reactive result from the data, will evaluate the exams based on the biophysical profile scores. The entire procedure takes less than an hour. Here’s how to better prepare for the exams:
- The profile is recommended to be performed from the 28th week of pregnancy onwards;
- Wear clothes that are comfortable;
- Try to eat 30 to 60 minutes before the exam, as this helps provoke a fetal reaction, which aids in assessment;
- Bring previous test results for comparison to evaluate fetal growth;
At the end of the whole process, you will probably be given the exam with the images and the report.
See Also: Glucose Tolerance Test – Why Is It Important?
Photo: Виталий Смолыгин
