Random Medical Fact #5: Biophysical Profile
04/17/07 14:52
Since I am on ob/gyn next, I'm reading a bit about it
now. You would think that having gone through it
(twice) would mean I knew most of this stuff already,
but it's really different experiencing it from the
other side. I really wasn't thinking like a medical
student when I was going to my appointments, and
whatever upper hand I might have had as a medical
student in terms of exposure has clearly now been
outweighed by my "mommy brain." And that doesn't even
include the sheer lack of time and energy to read
anything at the end of the day. You'd be amazed at
what people have said to me regarding how much easier
rotations must be because I experienced childbirth
and have kids. Seriously? Perhaps in terms of patient
empathy, but being a medical student mom doesn't make
it any easier to remember things like the BPP (I
don't remember ever having this assessed, and if it
was, I certainly didn't get a hands-on lecture about
it).
The Biophysical Profile (BPP) integrates 5 parameters as a tool for antenatal testing of fetal well-being, using real-time ultrasound:
1) nonstress test (NST) two or more episodes of fetal heart rate acceleration greater than 15bpm above baseline for at least 15 seconds, over a 20 minute period
2) breathing one or more episodes greater than 20 seconds long, within 30 minutes
3) movement two or more discrete body/limb movements or episodes within 30 minutes
4) tone one or more episodes of active extension with return to flexion of fetal limb(s) or trunk
5) amniotic fluid volume one or more pockets of fluid greater than 2cm in vertical axis, not to be confused with amniotic fluid index (AFI)*
Source: Manning FA: Fetal biophysical profile. Obstet Gynecol Clin North Am 1999 Dec; 26(4): 557-77
A score is assigned (0=abnormal, 2= normal) to each parameter, with a total score of 8-10 being reassuring for fetal well-being. First Aid includes a little mnemonic to help remember the parameters:
Test the Baby, MAN (tone, breathing, movement, amniotic fluid, nonstress test)
I have seen slight variations of the BPP in terms of scoring criteria, but are all pretty much the same in terms of assessing fetal well-being.
*An AFI measurement is the sum of highest vertical pocket of amniotic fluid (in cm) in each of four quadrants; <5cm = oligohydramnios, >25 = polyhydramnios. Along with the NST, it comprises the modified BPP.
The Biophysical Profile (BPP) integrates 5 parameters as a tool for antenatal testing of fetal well-being, using real-time ultrasound:
1) nonstress test (NST) two or more episodes of fetal heart rate acceleration greater than 15bpm above baseline for at least 15 seconds, over a 20 minute period
2) breathing one or more episodes greater than 20 seconds long, within 30 minutes
3) movement two or more discrete body/limb movements or episodes within 30 minutes
4) tone one or more episodes of active extension with return to flexion of fetal limb(s) or trunk
5) amniotic fluid volume one or more pockets of fluid greater than 2cm in vertical axis, not to be confused with amniotic fluid index (AFI)*
Source: Manning FA: Fetal biophysical profile. Obstet Gynecol Clin North Am 1999 Dec; 26(4): 557-77
A score is assigned (0=abnormal, 2= normal) to each parameter, with a total score of 8-10 being reassuring for fetal well-being. First Aid includes a little mnemonic to help remember the parameters:
Test the Baby, MAN (tone, breathing, movement, amniotic fluid, nonstress test)
I have seen slight variations of the BPP in terms of scoring criteria, but are all pretty much the same in terms of assessing fetal well-being.
*An AFI measurement is the sum of highest vertical pocket of amniotic fluid (in cm) in each of four quadrants; <5cm = oligohydramnios, >25 = polyhydramnios. Along with the NST, it comprises the modified BPP.
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