Biophysical profile test, why should pregnant women do it?

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Definition

What is a biophysical profile?

A biophysical profile test is a test to measure the health of your baby (fetus) in the womb. Biophysical profile tests include non-stress tests performed with an electronic fetal heart monitor and ultrasound. The biophysical profile measures the baby's heart rate, muscle shape, movement, breathing, and the amount of amniotic fluid around your baby.

Biophysical profiles are generally performed in the final trimester of pregnancy. If there may be a problem with your baby during pregnancy (high-risk pregnancy), a biophysical profile can be done at week 32-34 or earlier. Women with high-risk pregnancies can have a biophysical profile test weekly or twice a week in the third trimester.

When should I undergo a biophysical profile?

Mothers and babies who require special medical care and attention need a biophysical profile. This test is to check your baby's health. Some of the reasons for a biophysical profile test are:

• diabetes
• high blood pressure
• small babies or babies not growing well
• past the delivery deadline
• too much or too little fluid around the baby

The biophysical profile test is usually done once or twice a week. You will be made an appointment for the next test.

Precautions & warnings

What should I know before undergoing a biophysical profile?

The biophysical profile includes a non-stress test with an electronic fetal heart monitor and ultrasound. Many tests, such as the contraction stress test, may be recommended if your test results are abnormal. If there may be a problem with your baby during pregnancy (high-risk pregnancy), a biophysical profile can be done weekly or twice a week for the last 12 weeks of your pregnancy. A biophysical profile can be done after you have had an incident such as a fall or car accident. Your doctor will recommend multiple tests for the remainder of your pregnancy.

Process

What should I do before undergoing a biophysical profile?

Usually does not require special preparation for biophysical profile tests. Ultrasound is sometimes done when the bladder is full, but this is rare. If this is the case, you will be asked to drink water or other fluids right before the test so that you do not pass urine before or while doing the test. Usually tests in pregnant women in the third trimester do not require a full bladder.

If you smoke, you will be asked to stop smoking for 2 hours before the external monitoring test is done because smoking reduces your baby's activity.

How is the biophysical profile process?

Non-stress test

Fetal heart external monitoring will record your baby's moving and immobile heart rate. This is usually done before the fetal ultrasound.

External monitoring is done using two devices (sensors) that are placed over an elastic belt on your abdomen. One sensor reflects the results (ultrasound) of your baby's heart rate. Other sensors measure the duration of your contractions. The sensors are connected to a machine that records information. Your baby's heart rate can sound like a beeping sound or appear on a graph.

If your baby is moving or you have contractions, you may be asked to press a button on the machine. Your baby's heart rate is recorded and compared to record your movements or contractions. This test is usually done for 30 minutes.

Fetal Ultrasound

You don't usually need to take off your shirt for an ultrasound, you can either lift your shirt or lower your pants or skirt. If you are wearing a dress, you will be given a dress or paper to cover it to use during the test.

You may need a full bladder. You may be asked to drink 4-6 glasses of liquid, usually juice or plain water, about an hour before the test. A full bladder helps carry sound waves and pushes the intestines out of the uterus. This makes the ultrasound image clearer.

You won't be able to pass urine until the test is over. Tell the ultrasound specialist if you can't stand urinating so much that it hurts.

If the ultrasound is done late in pregnancy, a full bladder is not needed. The fetus that has grown large will push the intestines out.

You will lie on your back on the examination table. If you are short of breath or clasped on your back, your upper body needs to be raised or you need to change positions. A gel will be rubbed on your stomach.

A small handheld device called a transducer will be pressed against the gel on top of your skin and moved around your stomach several times. You can view a monitor to see your fetus during the test.

What should I do after undergoing a biophysical profile?

When this test is complete, the gel is removed from your skin. You can urinate immediately after this test is done. Abdominal ultrasound takes about 30-60 minutes.

The ultrasound officer is usually trained in showing the fetus in your womb, but he cannot tell you whether your fetus looks normal or not. Your doctor will provide this information to you after the ultrasound images have been studied by a radiologist or perinatologist.

Explanation of the Test Results

What do my test results mean?

A score of 8-10 points means that your baby is healthy. A score of 6-8 points means that you will need to retest within 12-24 hours. A score of 4 or less could mean your baby has a problem. Further tests will be recommended.

Biophysical profile
Measurement	Normal (2 points)	Abnormal (0 points)
Non-stress test	Increase in heart rate of 2 or more times, from at least 15 beats per minute. Each increase lasts 15 seconds or more and is seen with movement.	Only 1 time increase in heart rate is detected, or the heart rate does not increase by more than 15 beats with movement.
Movement of Breathing	1 or more breathing movements for at least 60 seconds.	Movement of breathing for less than 60 seconds, or no visible breathing.
Body movement	3 or more movements of the hands, feet, or body	Less than 3 movements of the hands, feet or body
Muscle Size	The functions of the arm and leg muscles are working and the head rests on the chest. One or more muscle extensions and movements, such as the hand opening or closing, are seen.	The fetus stretches out slowly and returns to its original position only half way. The fetus stretches but cannot return to its normal position. Hands, feet, or spine open, or hands open.
Amniotic fluid volume (amniotic fluid index)	One or more sacs of amniotic fluid are visible in the uterus, each at least 1 cm wide and long. The amniotic fluid index is between 5 cm and 24 cm.	Not enough amniotic fluid is seen in the uterus.