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    Patent Pending

    Fetal Biophysical Profile (BPP) Score

    Predicts need for urgent delivery based on sonographic and nonstress testing.
    When to Use
    Pearls/Pitfalls
    Why 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, see ACOG Practice Bulletin, Antepartum Fetal Surveillance (box 1, page 186).
    • 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).

    Helps determine if emergent delivery is required.

    <30 sec of breathing within 30 min
    0
    ≥1 episode of rhythmic breathing lasting ≥30 sec within 30 min
    +2
    <3 discrete movements
    0
    ≥3 discrete body or limb movements within 30 min
    +2
    0 extension/flexion events
    0
    ≥1 episode of extremity extension and subsequent return to flexion
    +2
    Largest single vertical pocket ≤2 cm
    0
    A pocket of amniotic fluid ≥2 cm in 2 perpendicular planes (2x2 cm pocket)
    +2

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Frank A. Manning

    About the Creator

    Frank A. Manning, MD, is a professor of obstetrics and gynecology and associate director of the maternal-fetal medicine division at New York Medical College. His research interests include fetal ultrasound and in utero fetal therapy. Dr. Manning is the author of seven books including Sonography in Obstetrics & Gynecology Principles and Practice.

    To view Dr. Frank A. Manning's publications, visit PubMed

    Content Contributors
    • Nai-Ming Cheng, MD
    About the Creator
    Dr. Frank A. Manning
    Content Contributors
    • Nai-Ming Cheng, MD