Biophysical Profile Scoring
Techniques and Interpretation
A score of 2 is assigned to each normal finding and 0 to each abnormal one for a maximum score of 10.
Normal findings (score = 2)
- Breathing movements: ≥ 1 episode of ≥ 20 seconds in 30 minutes.
- Body movements: ≥ 2 discrete body/limb movements in 30 minutes (episodes of active continuous movement is considered as a single movement).
- Tone: ≥ 1 episode of active extension with return to flexion of limb(s) or trunk (opening and closing of the hand is considered normal tone).
- Amniotic fluid volume: ≥ 1 pocket of fluid measuring ≥ 2 cm in 2 perpendicular planes.
- FHR reactivity: ≥ 2 episodes of acceleration of ≥ 15 bpm and of > 15 seconds associated with fetal movement in 20 minutes.
Abnormal findings (score = 0)
- Breathing movements: Absent or no episode of ≥ 20 seconds in 30 minutes.
- Body movements: < 2 episodes of body/limb movements in 30 minutes.
- Tone: Either slow extension with return to partial flexion, movement of limb in full extension, absent movement, or partially open hand.
- Amniotic fluid volume: Either no pockets or a pocket < 2 cm in 2 perpendicular planes.
- FHR reactivity: ≥ 1 episode of acceleration of FHR or acceleration of < 15 bpm in 20 minutes.
Management Protocol for Biophysical Profile Scoring
Scores of 8 and 10 are considered normal (unless a decrease in amniotic fluid is noted, in which case the infant may need to be delivered). Repeat testing is normally done weekly (some patients, such as diabetics and patients ≥ 42 weeks, are tested twice a week).
Scores of 4 and 6 are suspicious for chronic asphyxia. Repeat testing is normally done in 24 hours. If the repeat test is ≤ 6, delivery may be recommended.
Scores of 0 and 2 are strongly suspicious of chronic asphyxia. Testing time is usually extended to 120 minutes. A persistent score of ≤ 4 indicates delivery.