What Is a Biophysical Profile?

A biophysical profile (BPP) is a prenatal ultrasound that uses a scoring system to assess the health of your baby during pregnancy. It is most likely to be completed during the third trimester for women who have a high-risk pregnancy or if there’s a chance for complications.

If your healthcare provider recommends one, know that BPP testing is considered safe and it's non-invasive. It utilizes a non-stress test to evaluate the baby’s heartbeat and ultrasound technology to view the amniotic fluid, the baby’s movements, muscle tone, and breathing patterns. Each of these areas is given a score ranging from zero to two, with a possible combined score of 10 points. The average duration of a BPP test may last from 30 minutes to over an hour.

Purpose of Test

During pregnancy, both the health of the mother and the baby are crucial to maximize the potential for successful delivery and minimize complications. One way to determine the well-being of the baby is through BPP.

Some of the reasons your healthcare provider may choose to use this technology include:

• Evaluating the baby’s health, especially if you have a history of complications with previous pregnancies or your baby is two weeks past the expected due date
• You’re expected to deliver more than one baby (twins, triplets, etc.)
• Pregnancy-related health conditions like preeclampsia or unexplained bleeding
• You have pre-existing health conditions like chronic kidney disease, hyperthyroidism, lupus, high blood pressure, type 1 diabetes, or gestational diabetes (diabetes that develops during pregnancy)
• You have too much or too little amniotic fluid

Please note: There are other illnesses and health conditions that may require a BPP, but these are the most common.

Limitations

BBP is not 100 percent accurate. Potentially, the test could miss a problem with the health of the baby, or it could falsely indicate there’s an issue when there may not be. This could result in additional, and sometimes unnecessary, testing and anxiety.

However, the false-positive rates are considered low with this method of testing.

Results of a BPP, even if accurate, may not be able to predict or change the outcome of a pregnancy.

Risks and Complications

BPP doesn’t involve the use of radiation and is not invasive. Since it electrically monitors the baby’s heart rate and uses sound waves to create images, it does not pose a health risk to you or your baby.

Before the Test

BPP requires relatively little preparation, so you may have your test on the same day it's ordered or on a different day. Before the test, the healthcare provider will ask you about your health history—be sure to note any health conditions you’ve been diagnosed with.

Your healthcare provider will let you know if there are specific instructions you need to follow before having your BPP.

Timing

If you're having a full BPP, the test may last between 30 minutes to just over an hour. If you are having a modified BPD, the procedure may take as little as 20 minutes. In many cases, you may be able to find out the results of the test right after it’s finished.

Location

Testing may be done in a hospital, clinic, or healthcare provider’s office. Your obstetrician might perform the test themselves, or another healthcare practitioner, like an ultrasound technician or radiologist, may do it.

What to Wear  

There’s no set rule as to the type of clothing you need to wear for the test. You might be more comfortable in loose-fitted clothing that allows you to lie down and gives the healthcare provider access to your abdomen. In some situations, you may be asked to put on a gown.

Food and Drink

Generally, you can continue with your regular food and drink routine, but your healthcare provider may give you specific instructions. For example, you may be asked to drink liquids so that your bladder is full during the test. The particular instructions may vary, depending on your overall health and why you are having the test.

Other Considerations

When you show up for the test, bring your insurance card and any paperwork you’ve been asked to fill out.

Since BPP is a non-invasive test, you’re not required to have someone else drive you to and from the appointment, but you may feel more at ease having your spouse, partner, friend, or family member with you.

During the Test

The test will involve two components—the non-stress test portion and an ultrasound. Throughout the test, you’ll lie on a padded table with your belly exposed. Be sure to let your healthcare provider know if you’re uncomfortable, so they can place you in a position that’s more comfortable.

Throughout the Test

A non-stress test is a test that measures heart rate without any interventions that could affect the heart rate. When you undergo the non-stress test, a belt measuring the baby’s heart rate will be placed across your belly and recorded. Your baby may be sleeping, and your healthcare provider may decide to wait until your baby wakes up to continue the test. In other cases, the healthcare provider may attempt to arouse the baby gently.

The next portion of the test involves the ultrasound, where the baby’s breathing patterns, movements, muscle tone, and amniotic fluid volume will be evaluated. Here, your healthcare provider will apply a gel-like substance to your abdomen and place a small machine (a transducer) over your belly to obtain images of the baby.

After the Test  

Once the test is finished, your healthcare provider will wipe the gel off your abdomen and give you time to get dressed. You may or may not receive the results the same day. Typically, you’ll be allowed to go home, and your healthcare provider will notify you if you need to make arrangements for additional testing or appointments.

BPP does not cause side effects for a mother or baby.

Interpreting the Results

The BPP measures five areas of your baby's health (heart rate, breathing, movement, muscle tone, and amniotic fluid) on a numeric scale of zero to two.

When the scores are combined, results indicate the following:

• A total of eight to 10 indicates that your baby is healthy.
• A point total of six to eight will require you to have the test repeated in 12 to 24 hours.
• If the score is four or less, this indicates the baby is having problems, and further testing will be necessary to identify the challenges the baby may be facing.

In most cases, the results will be ready right after the test is completed. Whether it’s a routine exam or additional testing, your healthcare provider will provide you with appropriate follow-up instructions.

A Word From Verywell

For many people, the BPP testing process, from the waiting room to the test results, can provoke anxiety. To ease the process a bit, make sure you’re working with a healthcare provider with whom you feel you can openly communicate your worries and ask any pressing questions you may have. Prenatal care can help prevent or reduce the effects of complications.