What is a Biophysical Profile and Should I Have One Done? Everything You Need to Know

Pregnancy is an exciting time, but it can also bring a whirlwind of questions and concerns. As part of your antenatal care, you may have heard of a test called a biophysical profile (BPP). If you’re wondering what this test entails, whether it’s necessary, and how it can benefit you and your baby, you’re not alone. This article will provide a thorough explanation of the biophysical profile, the reasons it’s performed, and whether you should consider having it done as part of your antenatal appointments.

What is a Biophysical Profile (BPP)?

A biophysical profile (BPP) is a prenatal test that assesses the health of your baby by measuring certain physical characteristics and behaviours. This test combines an ultrasound scan with a non-stress test (NST), providing valuable information about your baby’s well-being. The antenatal scan helps assess key indicators such as the baby’s movements, breathing patterns, muscle tone, and the amount of amniotic fluid present. It is a non-invasive test that doesn’t pose any risks to you or your baby, and the results can provide valuable insight into your baby’s health, especially in high-risk pregnancies or in cases where there might be concerns about the baby’s development or the overall pregnancy. The NHS offers biophysical profiles (BPPs) free of charge as part of standard antenatal care for pregnant individuals who meet specific medical criteria. A BPP is typically recommended in certain high-risk pregnancies, or when there are concerns regarding the baby’s well-being, such as in cases of intrauterine growth restriction (IUGR), gestational diabetes, or pre-eclampsia. In these instances, a BPP may be carried out at an antenatal clinic or hospital, often after a discussion between the pregnant person and their healthcare provider. The cost of the procedure, including any ultrasounds or non-stress tests, will be covered under the NHS system, so there is no charge for patients who are eligible. If you’re concerned about whether you qualify for a BPP, it’s best to speak with your midwife or obstetrician during your antenatal appointments. They will assess your situation and decide if the test is necessary for your pregnancy care.

How is a Biophysical Profile Done?

The test consists of two main components:

1. Ultrasound: This part of the BPP involves an ultrasound scan, where the technician will observe the baby’s movements, muscle tone, breathing activity, and the amount of amniotic fluid around the baby. Each of these areas is scored, and the results are given as a score out of 8 or 10.
   • Baby’s movements: The ultrasound will check how actively your baby is moving. A baby that is moving around normally usually scores well.
   • Baby’s muscle tone: The test looks at how well the baby can move its arms and legs. A healthy baby should be able to flex and extend its limbs.
   • Breathing movements: This refers to the baby’s ability to practice “breathing” movements, even though they aren’t actually breathing in the traditional sense, as they get oxygen through the placenta.
   • Amniotic fluid: The technician will measure the amount of amniotic fluid around the baby. A normal level of fluid is essential for the baby’s development, and insufficient fluid could indicate potential problems.
2. Non-Stress Test (NST): This part of the test measures the baby’s heart rate in response to movements. During the NST, sensors will be placed on your abdomen, and the baby’s heart rate is monitored as you rest. A healthy baby’s heart rate should increase with movements, reflecting a normal, active response. The two components of the test together provide a comprehensive picture of how your baby is doing.

What is the Purpose of a Biophysical Profile?

The main goal of the BPP is to assess how well your baby is coping with the conditions in the womb. It can be especially useful in detecting potential problems early on, so that you can receive the proper antenatal care. Some of the key purposes of a BPP include:

• Assessing fetal well-being: A BPP can identify if there are signs of fetal distress, which might indicate that your baby isn’t getting enough oxygen or nutrition.
• Monitoring high-risk pregnancies: If you are at higher risk of complications due to conditions like pre-eclampsia, gestational diabetes, or poor growth, a BPP can provide valuable information. The test is also recommended for women carrying multiples (twins, triplets, etc.), who have a higher chance of complications.
• Investigating concerns: If your healthcare provider has concerns about the baby’s growth or movement, the BPP can provide critical data that helps make decisions about whether further intervention is needed, or if early delivery is necessary.
• Reducing stillbirth risk: The BPP can help detect potential complications early, reducing the risk of stillbirth by enabling early intervention.

When is a Biophysical Profile Performed?

A BPP is typically done in the third trimester of pregnancy, usually around 28 weeks or later, although it may be performed earlier in certain situations. It is often recommended in the following circumstances:

• Post-term pregnancies: If your pregnancy extends beyond 40 weeks, your doctor may suggest a BPP to assess the baby’s health.
• Low or high amniotic fluid levels: If previous antenatal scans have shown concerns with the amniotic fluid, a BPP can help monitor the situation.
• Intrauterine growth restriction (IUGR): If your baby is not growing as expected, a BPP can evaluate the cause of this and whether early delivery might be necessary.
• Maternal health conditions: Conditions like pre-eclampsia, high blood pressure, or gestational diabetes might prompt your healthcare provider to recommend a BPP to monitor how these factors affect your baby.

What Are the Results of a Biophysical Profile?

After the test, you will receive a score based on the results from the ultrasound and NST. The BPP is usually scored out of 10 points:

• 8-10 points: This is considered normal. Your baby is likely doing well, and no immediate action is needed.
• 6 points: This may suggest that your baby could be at risk and further tests or monitoring may be needed.
• 4 points or fewer: This often indicates that the baby might be in distress, and your doctor may recommend additional interventions such as early delivery or a hospital stay for further monitoring. If your score is low, it doesn’t necessarily mean there is a serious problem. However, your healthcare provider will take the results into consideration and may recommend additional testing or monitoring to ensure the best possible care for you and your baby.

Should You Have a Biophysical Profile Done?

Whether or not you should have a BPP performed depends on various factors, such as your pregnancy’s progress and your overall health. While not every pregnancy requires a BPP, it can be an essential tool in managing antenatal care for certain women. Here are some considerations to keep in mind:

• Risk Factors: If you have any risk factors for complications (e.g., gestational diabetes, pre-eclampsia, or maternal hypertension), a BPP can provide valuable information about your baby’s health and help you make informed decisions about your pregnancy.
• Your Doctor’s Recommendations: If your healthcare provider suggests a BPP, it is likely because they want to monitor the well-being of your baby. While the decision is ultimately yours, following their advice could be beneficial for your baby’s health.
• Peace of Mind: Some women choose to have a BPP done as a precautionary measure to help provide peace of mind, especially if they are feeling anxious about their pregnancy.

Antenatal Support and Peace of Mind

Throughout your pregnancy, your healthcare team will be there to offer antenatal support and guide you through decisions about tests like the BPP. If you feel uncertain about whether this test is right for you, don’t hesitate to discuss it further with your doctor. Your provider can explain the reasons for recommending the test and help you understand its potential benefits. If you’re looking for additional ways to support your pregnancy health, consider practices such as antenatal yoga, prenatal massage, or even joining antenatal classes to stay informed and reduce stress. These activities are excellent for both physical and emotional well-being, providing a comprehensive approach to antenatal care. A biophysical profile is a helpful diagnostic tool that can assess your baby’s health during pregnancy. It’s especially useful for monitoring high-risk pregnancies or investigating concerns that might arise during routine antenatal scans. While not every pregnancy requires a BPP, it can provide peace of mind and help ensure your baby’s well-being in certain situations. Remember, whether you’re having a BPP or simply attending your regular antenatal appointments, the goal is to provide the best care for you and your baby. Take comfort in knowing that the antenatal care you receive is designed to support you through every step of your pregnancy, so you can focus on the exciting journey ahead.