Biophysical Profile

Theory: Assesses function of regulatory centers in the brain that may be affected by ischemia, hypoxemia, and/or acidemia.

Two points for each of the following during a 30 minute observation period:

• Reassuring non-stress test, i.e. two accelerations and no late or variable decelerations

• Deepest vertical amniotic fluid pocket measuring 2 cm or greater (measured in all 4 quadrants)

• Fetal breathing movements for 30 seconds or longer (timed movement is cumulative, not continuous)

• Fetal tone, i.e. extension of the spine or an extremity with return to flexion

• Three or more discrete limb movements

Scoring interpretation

• 10: Reassuring; continue routine prenatal care

• 8: Interpretation depends on fluid status

  • No oligohydramnios: Reassuring with risk of stillbirth <1/1000 within 1 week

  • Oligohydramnios present: Deliver at 36-37 WGA

• 6: Non-predictive

  • 37 WGA or greater: Deliver

  • <37 WGA: Repeat test in 24 hours

• <6/10: Concerning with risk for fetal asphyxia ~90/1000 within 1 week

  • 32 WGA or greater: Consult maternal fetal medicine and deliver

  • <32 WGA: Consult maternal fetal medicine; individualize treatment plan

Note: Oligohydramnios is defined as no amniotic fluid pocket measuring >2cm