Biophysical Profile

The biophysical profile (BPP) is an ultrasound assessment of fetal well-being. It was originally designed to mimic the Apgar score for postnatal assessment. The BPP is technically more difficult to perform and interpret but provides a greater degree of certainty of fetal well-being. During a 30-minute examination, certain behavioral patterns associated with a healthy fetus are documented. The test is scored with five components, each worth 2 points (Table 21-11). Indicators such as amniotic fluid volume, fetal breathing, fetal heart rate, movement, and tone are evaluated. A score of 8 or 10 is reassuring; a score of 6 is suspicious and indicates a need for further evaluation; and a score of 4 or less is ominous, indicating the need for immediate intervention. A low score may also reflect the fetus's behavioral state during the test, such as normal sleep or sedation from maternal use of narcotics or CNS depressants. However, a decreasing score has been well correlated with poor outcome and with increasing degrees of fetal acidemia.

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