Biophysical Profile Score (BPS or BPP)
The biophysical profile score is a method used to asses the well being of a
fetus at increased risk for death or damage in utero.
The biophysical profile score evaluates the fetus for the presence of five
biophysical parameters using ultrasound and an electronic fetal heart rate
A score of 2 points is given for each parameter that meets criteria.
The test is continued until all
criteria are met or 30 minutes have elapsed.
The points are then added for a maximum score of 10.
|Fetal Breathing Movements
||One or more episodes of fetal
breathing lasting at least 30 seconds within 30 minutes.
||No episodes of
fetal breathing movements lasting at least 30 seconds during a 30 minute period
||3 or more discrete body or limb
movements within 30 minutes
||Less than 3 body or limb movements in 30
more episodes of active extension and flexion of a fetal extremity OR opening
and closing of the hand within 30 minutes
||Slow extension with no return or
slow return to flexion of a fetal extremity OR no fetal movement
|Amniotic Fluid Volume
||A single deepest vertical pocket of
amniotic fluid measures greater than 2 centimeters. is present
A single deepest vertical pocket of amniotic fluid
measures 2 centimeters or less
*Amniotic Fluid Volume Measured as the vertical measurement , in
centimeters, of the single deepest pocket of amniotic fluid with a transverse
measurement of 1 cm or more wide without fetal
small parts or umbilical cord . 
** Reactive =
Two or more fetal heart rate
accelerations that peak (but do not necessarily remain) at least 15 beats per minute
above the baseline and last at least 15 seconds from baseline to baseline
during 20 minutes of observation
**Nonreactive = Less than two accelerations of fetal
heart rate as described above after 40 minutes of observation 
A total score of 8 or 10 is normal, a score of
6 is considered equivocal, and a score of 4 or less is abnormal [1,3,6].
The Modified Biophysical Profile
Some testing centers use a modified BPP [4,5]. The modified BPP consists of the
nonstress test (NST) and an amniotic fluid volume assessment. The modified BPP
is considered normal if the NST is reactive and the deepest vertical pocket of
amniotic fluid is greater than 2 centimeters. The modified BPP is
considered abnormal if either the NST is nonreactive or the deepest vertical
pocket of amniotic fluid is 2 cm or less .
1. Antepartum fetal surveillance.
Practice Bulletin No. 145. American College of Obstetricians and Gynecologists.
Obstet Gynecol 2014;124:182–92PMID:24945455
2. Chamberlain PF, Manning FA, Morrison I, Harman CR,
Lange IR. Ultrasound evaluation of amniotic fluid volume. I. The relationship of
marginal and decreased amniotic fluid volume to perinatal outcome. Am J Obstet
Manning FA, et. al., Fetal assessment based on fetal biophysical profile
scoring: experience in 12,620 referred high-risk pregnancies. I. Perinatal
mortality by frequency and etiology.Am J Obstet Gynecol. 1985 Feb 1;151(3):343-50. PMID: 3881967
4. Nageotte MP, et. al. Perinatal outcome with the modified biophysical profile.
Am J Obstet Gynecol. 1994 Jun;170(6):1672-6. PMID:8203424
5.Miller DA, et. al., The modified biophysical profile: antepartum testing in
the 1990s.Am J Obstet Gynecol. 1996 Mar;174(3):812-7. PMID:8633648
Fetal health surveillance: antepartum and intrapartum consensus guideline. Liston R, Sawchuck D, Young D; Society of Obstetrics and Gynaecologists of
Canada; British Columbia Perinatal Health Program.
J Obstet Gynaecol Can. 2007 Sep;29(9 Suppl 4):S3-56. Erratum in: J Obstet
Gynaecol Can. 2007 Nov;29(11):909. PMID:17845745