OBSTETRIC SCAN FOR BIOPHYSICAL PROFILE (BPP)

The third trimester of pregnancy is a time of anticipation and final preparations. To ensure your baby is thriving during these final weeks, your doctor may recommend a Biophysical Profile (BPP) Test. This common, non-invasive prenatal test provides a comprehensive health check for your baby. At Cadabams Diagnostics, we use this advanced test for the primary purpose of assessing fetal well-being, giving you peace of mind and providing your healthcare team with vital information. The BPP test combines two key assessments—a non-stress test (NST) and a detailed ultrasound—to create a complete and accurate picture of your baby's health inside the womb.

What is a Biophysical Profile Test?

Think of a Biophysical Profile (BPP) Test as a detailed physical exam for your baby before they are born. It's a safe and painless way for your doctor to observe how your baby is doing. The test is made up of two distinct parts that work together:

1. The Non-Stress Test (NST): This part of the test monitors your baby's heart rate to see how it responds to movement. A healthy, well-oxygenated baby's heart will beat faster when they move, just as yours does during exercise.
2. The Ultrasound Assessment: This is the "biophysical profile" component. Using standard ultrasound technology, a skilled sonographer at Cadabams Diagnostics will create real-time images of your baby. These images allow us to observe four specific activities and conditions, giving us direct insight into the baby’s central nervous system and overall health.

By combining the non-stress test and biophysical profile ultrasound, your doctor gets a reliable and in-depth view of your baby's condition, helping to guide decisions about your care and the timing of delivery.

Types of Biophysical Profile Test

While the comprehensive BPP is common, your doctor may sometimes order a slightly different version depending on your specific situation.

• Standard BPP: This is the complete test that assesses all five key parameters. It includes the Non-Stress Test (NST) and the four ultrasound markers: fetal breathing, body movement, muscle tone, and amniotic fluid volume. This is the most thorough version of the test.
• Modified BPP (mBPP): This is a quicker, more streamlined assessment that combines only two critical components: the Non-Stress Test (NST) and the Amniotic Fluid Index (AFI). The AFI is a measurement of the amniotic fluid volume. The mBPP is often used as a primary screening tool for fetal well-being, and if the results are concerning, a full Standard BPP may then be performed.

At Cadabams Diagnostics, our team will perform the specific test ordered by your healthcare provider, ensuring you receive the appropriate level of care.

The BPP score is calculated by assessing five specific markers of fetal health. Each parameter is given a score of 2 if it's normal or 0 if it's abnormal. The goal is a total score of 8 or 10.

The five key parameters are:

1. Fetal breathing movements: Observing the baby's chest moving in a breathing-like motion.
2. Gross body movements: Watching for the baby moving their limbs or entire body.
3. Fetal muscle tone: Looking for at least one instance of the baby flexing and extending a limb, or opening and closing a hand.
4. Amniotic fluid volume: Measuring the amount of fluid in the amniotic sac to ensure it's adequate.
5. Fetal heart rate: This is measured during the Non-Stress Test (NST) to see if the baby's heart rate accelerates appropriately with movement.

Your doctor's primary goal is to ensure a safe and healthy outcome for your pregnancy. The BPP test is a valuable tool ordered for specific medical reasons, including:

• Post-term Pregnancy: Going significantly past your due date (e.g., beyond 41 weeks) can increase risks, as the placenta may become less efficient. A BPP helps monitor the baby’s health in this scenario.
• Maternal Health Concerns: Conditions like chronic high blood pressure, preeclampsia, diabetes, or autoimmune diseases like lupus can affect placental function and fetal oxygen supply.
• Concerns About Fetal Growth: If your baby appears to be smaller than expected (Intrauterine Growth Restriction - IUGR) or there are other growth concerns, a BPP can help assess their condition.
• History of Pregnancy Loss: For individuals who have experienced a previous late-term pregnancy loss, regular BPP testing can provide reassurance and early detection of potential issues.
• Decreased Fetal Movement: A mother's perception of reduced movement is a common and important reason to perform a BPP to check on the baby.
• Oligohydramnios or Polyhydramnios: The test is used to monitor pregnancies with too little (oligo) or too much (poly) amniotic fluid.

The test is frequently recommended for those managing to provide an extra layer of monitoring.

Types of Biophysical Profile Test

While the comprehensive BPP is common, your doctor may sometimes order a slightly different version depending on your specific situation.

• Standard BPP: This is the complete test that assesses all five key parameters. It includes the Non-Stress Test (NST) and the four ultrasound markers: fetal breathing, body movement, muscle tone, and amniotic fluid volume. This is the most thorough version of the test.
• Modified BPP (mBPP): This is a quicker, more streamlined assessment that combines only two critical components: the Non-Stress Test (NST) and the Amniotic Fluid Index (AFI). The AFI is a measurement of the amniotic fluid volume. The mBPP is often used as a primary screening tool for fetal well-being, and if the results are concerning, a full Standard BPP may then be performed.

At Cadabams Diagnostics, our team will perform the specific test ordered by your healthcare provider, ensuring you receive the appropriate level of care.

Benefits of Taking the Obstetric Scan for Biophysical Profile (BPP)

Undergoing a Biophysical Profile (BPP) Test offers several key benefits for you and your baby:

• Provides Reassurance: A normal BPP score is highly reassuring, confirming that your baby is healthy and receiving enough oxygen. This can significantly reduce anxiety, especially in a high-risk pregnancy.
• Guides Clinical Decisions: The results help your doctor make crucial, informed decisions. A good score may allow your pregnancy to continue safely, while a low score can guide the decision about the right time for delivery.
• Allows for Early Intervention: The primary benefit is its ability to detect early signs of fetal distress. If the test indicates a potential problem, your medical team can intervene promptly, which may involve increased monitoring or delivering the baby before the issue becomes critical.
• Non-Invasive and Safe: It provides a wealth of information without posing any physical risk to you or your baby.

Illnesses Diagnosed with Obstetric Scan for Biophysical Profile (BPP)

It is critical to understand that the Biophysical Profile (BPP) Test does not diagnose a specific illness or birth defect. Instead, its purpose is to identify signs of fetal compromise or distress.

A low score suggests that the baby may not be receiving enough oxygen or that their central nervous system is not functioning optimally. This distress could be caused by various underlying issues, such as:

• Placental insufficiency (the placenta is not working well)
• Umbilical cord compression
• Severe fetal anemia
• Maternal health complications

A low BPP score is a red flag that tells your doctor, "Something is not right; we need to investigate further or act now." The test identifies a state of being (distress) rather than a specific disease.

What should be done in order to prepare for the scan: 

• Wear your clothing relaxed 
• Arrive with a filled bladder 
• Remember to take any medical history or any ultrasound scans you may have 

Pre-requisites 

While there aren’t detailed pre-requisites for the BPP scan, it is a good idea to: 

• Speak to your healthcare professional about existing health problems or issues that might cause worry. 
• Adhere to any guidelines given to you by your healthcare provider. 

Best Timing Obstetric Scan Biophysical Profile (BPP) Has to Be Done  

As is the case with most scans, the BPP scan is best conducted between 28 and 40 weeks gestation. It can be done earlier or later depending on the individual case.  

Eligibility  

The scan BPP is usually advised for all women during pregnancy, but it is especially useful for those mothers that have a higher chance of complications.  

Procedure for Taking an Obstetric Scan for Biophysical Profile (BPP)  

The duration of time taken to perform the scan is between 30 - 60 minutes. The procedure consists of:  

1. Step 1: Preparation – You will be asked to lie on the exam table with you abdomen exposed.  
2. Step 2: Apply ultrasound gel – Gel is then applied to the abdomen for imaging purposes.  
3. Step 3: Carry out ultrasound – The sonographer uses the transducer to get images of the foetus and assess the five parameters of BPP. 
4. Non-Stress Test (NST): The sonographer needs to do NST to evaluate fetal heart rate’s response to movement. 
5. Review and discussion: The sonographer will review the images together with you and discuss findings or recommendations, if any. 

Caution Before Taking the Test 

Remember to: 

• Inform your doctors of your medical history or any other issues you might have 
• Adhere to any additional directions your doctor may have issued 
• Present with a distended bladder