What is a Fetal Biophysical Profile (BPP)?

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Biophysical Profile

A fetal Biophysical Profile, or BPP, is a prenatal test given when a baby’s health and well-being is in question. The test may be given either after an abnormal examination, in response to certain maternal/fetal symptoms, or if the pregnancy is considered high risk.  A BPP is most often performed on patients at risk of pregnancy loss and is usually given after 32 weeks of pregnancy.  It is a noninvasive test that has no physical risks to the mother or baby, but can detect fetal hypoxia (insufficient oxygen to the baby).       

The BPP test combines fetal heart rate monitoring (also known as a nonstress test) with a fetal ultrasound, and measures the baby’s heart rate, breathing, movements, muscle tone and the amount of amniotic fluid surrounding the baby.  A low BPP score may indicate that mother and baby need further monitoring or special care, and may necessitate early or immediate delivery in order to avoid permanent injury to the baby.  When the BPP identifies a baby at risk for injury, measures can be taken to intervene before progressive metabolic acidosis (buildup of damaging acid in the blood due to lack of oxygen) leads to permanent injury or fetal death.  

Your obstetrician will determine whether and when a BPP should be performed.  A BPP is most commonly recommended if the mother is carrying multiple babies, has diabetes or heart disease, is at least two weeks past the baby’s due date or has a history of pregnancy loss or previous pregnancy complications.  Other reasons that a BPP might be suggested are for decreased fetal movements or possible fetal growth problems, preterm rupture of the membranes (before 37 weeks), too much amniotic fluid (polyhydramnios) or low amniotic fluid volume (oligohydramnios).  Your obstetrician may initially suggest a modified BPP, which is a simplified version of the test that includes a nonstress test and measures the amniotic fluid through an ultrasound.  Depending on the results of the modified test, your obstetrician may order a full BPP.

Once ordered, your obstetrician may recommend that you have a BPP once a week or even more frequently until you deliver.  A BPP requires no special preparations by the mother and can usually be performed in your obstetrician’s office or at the hospital.  It can take up to an hour to complete.  Results are typically available right after the BPP is performed.  A score of 8 to 10 is reassuring, while a score of 6 or lower typically leads to a repeat BPP.  A repeat score of 6 or lower may lead your obstetrician to recommend further testing or an early or immediate delivery.  Regardless of your score, if the BPP determines that you have a low amount of amniotic fluid, you will require further testing which may warrant immediate delivery of your baby.  

A BPP is not recommended for a baby at term when there is a high likelihood of successful induction or when vaginal delivery is contraindicated for maternal or fetal reasons.

If you had a vaginal delivery after receiving a low score on your BPP and your baby suffered as a result, please contact our expert birth injury lawyers for help. Call us at 877-262-9767 to discuss your situation.

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