Biophysical profiles

Abstract

Fetal biophysical profile (BPP) scoring has become a common test of fetal wellbeing. Since its development in 1980, links between fetal acidaemia, hypoxaemia and loss of dynamic ultrasound biophysical variables have been established in both animal experimentation and in the human fetus. Large prospective studies using the various scoring systems have demonstrated very low false-negative rates in many groups of high-risk pregnancies. Systematic review of the evidence from studies where the test results were not revealed or from randomized trials have not shown a clear benefit for the use of full BPP scoring over other monitoring techniques. Studies of individual groups of high-risk pregnancies reveal conflicting evidence, but only in twin pregnancies and preterm prelabour rupture of the membranes does the bulk of evidence support the use of profile scoring over other techniques. In current practice truncated testing with liquor volume, cardiotocography and umbilical Doppler appears more appropriate as a 'routine' testing schedule, with BPP being reserved for cases where these are abnormal.