_id

683a1620c782e11e38d1b1ef

id

4024

title

Fetal Biophysical Profile (BPP) Score

full_title

Fetal Biophysical Profile (BPP) Score

short_title

BPP Score

med_description

Predicts need for urgent delivery based on sonographic and nonstress testing.

short_description

Urgent delivery.

slug

fetal-biophysical-profile-bpp-score

description

The Fetal Biophysical Profile (BPP) Score assesses for fetal distress based on sonographic and nonstress testing.

keywords

Bpp, biophysical profile, sono, fetal distress, manning

complaint

[ "Abdominal Pain" ]

formula

Addition of the selected points: *If largest vertical amniotic fluid pocket ≤2 cm. **May omit if all four sonographic components are normal.

evidence

The Biophysical Profile (BPP) was proposed by Manning in 1980. He derived and applied the BPP to 216 high-risk pregnancy patients and compared their perinatal outcomes. Results suggested that BPP can be an accurate method of antepartum fetal evaluation.

A subsequent study was performed in 2,712 patients receiving 7,851 tests of BPP evaluation but with reduced use of non-stress test (NST). Results showed no measurable change in test accuracy if other four ultrasound parameters are normal. Therefore, NST can be omitted and presumed normal if ultrasound parameters are normal (Manning 1987).

Kim et al validated the BPP Score in 100 patients with singleton pregnancies in active labor phase. Results showed that BPP is a good predictor for cesarean delivery and need for NICU admission. The use of oxytocics, prostaglandins, or epidural anesthesia did not influence BPP score (Kim 2003).

A modified BPP exists, which takes less time to perform and seems to have similar accuracy in predicting perinatal outcome (Nagoette 1994). Still, the full BPP provides more detailed information to help decision-making when facing suspected fetal distress.

measurements

[]

information

Interpretation:

From Manning 1980.

refrences

{ "Clinical Practice Guidelines": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/24945455", "text": "Practice bulletin no. 145: antepartum fetal surveillance. Obstet Gynecol. 2014;124(1):182-92." } ], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/7355965", "text": "Manning FA, Platt LD, Sipos L. Antepartum fetal evaluation: development of a fetal biophysical profile. Am J Obstet Gynecol. 1980;136(6):787-95." } ], "Other References": [ { "href": "", "text": "Bloom S, Cunningham F, Spong CY et al. Williams Obstetrics 24/E. McGraw-Hill Education / Medical; 2014." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/8203424", "text": "Nageotte MP, Towers CV, Asrat T, Freeman RK. Perinatal outcome with the modified biophysical profile. Am J Obstet Gynecol. 1994;170(6):1672-6." } ], "Outcomes": [], "Validation": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/12962926 ", "text": "Kim SY, Khandelwal M, Gaughan JP, Agar MH, Reece EA. Is the intrapartum biophysical profile useful?. Obstet Gynecol. 2003;102(3):471-6." } ], "Validations": [] }

pearls

• Nonstress test can be omitted and presumed normal if all four sonography parameters are normal (2 points for each).
• Of five fetal parameters, four are acute (nonstress test, fetal breathing, fetal movement, and fetal tone) and one is chronic (amniotic fluid volume).

usecase

• Use in pregnant patients, generally in the third trimester.
• Should be administered by users familiar with interpretation of fetal heart rate monitoring and fetal ultrasound.
• Indicated in pregnancies with risk of antepartum fetal demise, including maternal conditions (e.g. antiphospholipid syndrome, poorly-controlled hyperthyroidism) and pregnancy-related conditions (e.g. gestational hypertension, intrauterine growth restriction). For full list, see ACOG Practice Bulletin, Antepartum Fetal Surveillance (box 1, page 186).

reasons

Helps determine if emergent delivery is required.

next_advice

next_actions

Consult neonatology if fetal asphyxia is suspected.

next_management

diseases

[ "Pregnancy" ]

input_schema

[ { "conditionality": "", "default": null, "label_en": "Fetal breathing", "mdcalc_info_concept": null, "name": "breathing", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<30 sec of breathing within 30 min", "value": 0 }, { "label": "≥1 episode of rhythmic breathing lasting ≥30 sec within 30 min", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": null, "label_en": "Fetal movement", "mdcalc_info_concept": null, "name": "movement", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<3 discrete movements", "value": 0 }, { "label": "≥3 discrete body or limb movements within 30 min", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": null, "label_en": "Fetal tone", "mdcalc_info_concept": null, "name": "tone", "option_fhir_rules": null, "optional": false, "options": [ { "label": "0 extension/flexion events", "value": 0 }, { "label": "≥1 episode of extremity extension and subsequent return to flexion", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": null, "label_en": "Amniotic fluid volume (AFV)", "mdcalc_info_concept": null, "name": "volume", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Largest single vertical pocket ≤2 cm", "value": 0 }, { "label": "A pocket of amniotic fluid ≥2 cm in 2 perpendicular planes (2x2 cm pocket)", "value": 2 } ], "show_points": true, "tips_en": "If largest vertical amniotic fluid pocket ≤2 cm", "type": "radio" }, { "conditionality": "breathing + movement + tone + volume < 8", "default": null, "label_en": "Nonstress test (NST)", "mdcalc_info_concept": null, "name": "test", "option_fhir_rules": null, "optional": false, "options": [ { "label": "0 or 1 acceleration within 20–40 min", "value": 0 }, { "label": "≥2 accelerations of ≥15 beats/min for ≥15 sec within 20–40 min", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "breathing + movement + tone + volume == 8", "default": null, "label_en": "Nonstress test (NST)", "mdcalc_info_concept": null, "name": "test_normal", "option_fhir_rules": null, "optional": false, "options": [ { "label": "0 or 1 acceleration within 20–40 min", "value": 0 }, { "label": "≥2 accelerations of ≥15 beats/min for ≥15 sec within 20–40 min", "value": 2 }, { "label": "NST not done", "value": 3 } ], "show_points": false, "tips_en": "May omit if all four sonographic components are normal", "type": "radio" } ]

instructions

published

2022-04-21T20:29:37.581Z

purpose

[ "Prognosis" ]

search_terms

[ "BPP", "biophysical profile", "sono", "fetal distress" ]

seo

{ "keywords_en": "Bpp, biophysical profile, sono, fetal distress, manning", "meta_description_en": "The Fetal Biophysical Profile (BPP) Score assesses for fetal distress based on sonographic and nonstress testing." }

specialty

[ "OB-Gyn" ]

departments

[ "Reproductive" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10433, "short_title_en": "VBAC (MFMU)", "slug": "vaginal-birth-after-cesarean-vbac" }, { "calcId": 3317, "short_title_en": "VBAC Risk Score (Flamm)", "slug": "vbac-risk-score-successful-vaginal-delivery-flamm-model" }, { "calcId": 3320, "short_title_en": "Bishop Score", "slug": "bishop-score-vaginal-delivery-induction-labor" } ]

ismed

true

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "gynecology" ]

cleaned_use

[ "Use in pregnant patients, generally in the third trimester.", "Should be administered by users familiar with interpretation of fetal heart rate monitoring and fetal ultrasound.", "Indicated in pregnancies with risk of antepartum fetal demise, including maternal conditions (e.g. antiphospholipid syndrome, poorly-controlled hyperthyroidism) and pregnancy-related conditions (e.g. gestational hypertension, intrauterine growth restriction). For full list, seeACOG Practice Bulletin, Antepartum Fetal Surveillance(box 1, page 186)." ]

pub

false