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A biophysical profile is a prenatal ultrasound evaluation of fetal well-being involving a scoring system, with the score being termed Manning's score. It is often done when a non-stress test is non reactive, or for other obstetrical indications.
The "modified biophysical profile" consists of the nonstress test and amniotic fluid index only.
The biophysical profile (BPP) has 5 components: 4 ultrasound (US) assessments and a nonstress test (NST). The nonstress test (NST)(CTG) evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables:
|Parameter||Normal (2 points)||Abnormal (0 points)|
|NST/Reactive FHR||At least two accelerations in 20 minutes||Less than two accelerations to satisfy the test in 20 minutes|
|US: Fetal breathing movements||At least one episode of > 30s or >20s in 30 minutes||None or less than 30s or 20s|
|US: Fetal activity / gross body movements||At least three or two movements of the torso or limbs||Less than three or two movements|
|US: Fetal muscle tone||At least one episodes of active bending and straightening of the limb or trunk||No movements or movements slow and incomplete|
|US: Qualitative AFV/AFI||At least one vertical pocket> 2 cm or more in the vertical axis||Largest vertical pocket</=2 cm|
Each assessment is graded either 0 or 2 points, and then added up to yield a number between 0 and 10. A BPP of 8 or 10 is generally considered reassuring. A BPP normally is not performed before the second half of a pregnancy, since fetal breathing movements do not occur in the first half.
The presence of these biophysical variables implies absence of significant central nervous system hypoxemia/acidemia at the time of testing. By comparison, a compromised fetus typically exhibits loss of accelerations of the fetal heart rate (FHR), decreased body movement and breathing, hypotonia, and, less acutely, decreased amniotic fluid volume.