Fetal Monitoring, Biophysical Profile

ExitCare ImageThis test measures and evaluates 5 observations of the baby. These include the nonstress test, the baby's breathing, movements, muscle tone and the amount of amniotic fluid. The reason to monitor your baby (fetus) before birth is to identify and correct problems that may prevent serious problems from developing with the fetus, including fetal loss. Some pregnancies are complicated by the mother's medical problems. Some of these problems are type 1 diabetes mellitus, high blood pressure and other chronic medical illnesses. This is why it is important to monitor the baby before birth.

OTHER TECHNIQUES FOR MONITORING YOUR BABY BEFORE BIRTH:

Several fetal observation tests are in use. These include:

  • Fetal movement assessment (FMA). This is done by the pregnant woman herself by counting and recording the baby's movements over a certain time period.

  • Nonstress test (NST). This test monitors the baby's heart rate when the baby moves.

  • Contraction stress test (CST). This test monitors the baby's heart rate during a contraction of the uterus.

  • Modified BPP. This measures the volume of fluid in different parts of the amniotic sac (amniotic fluid index) and the results of the nonstress test.

  • Umbilical artery doppler velocimetry. This evaluates the blood flow through the umbilical cord.

There are several very serious problems that cannot be predicted or detected with any of the fetal monitoring procedures. These problems include separation (abruption) of the placenta or when the fetus chokes on the umbilical cord (umbilical cord accident).

Your caregiver will help you understand the tests and what they mean for you and your baby. It is your responsibility to obtain your test results.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any medications you are taking including prescription and over-the-counter drugs, herbs, eye drops and creams.

  • If you have a fever.

  • If you have an infection.

  • If you are sick.

RISKS AND COMPLICATIONS

There are no risks or complications to the mother or the fetus.

BEFORE THE PROCEDURE

  • Do not take medications that may increase or decrease the baby's heart rate and/or movements.

  • Eat a full meal at least 2 hours before the test.

  • Do not smoke if you are pregnant. If you smoke, stop at least 2 days before the test. It is best not to smoke at all when you are pregnant.

PROCEDURE

The BPP contains five parts:

  • Nonstress test.

  • Fetal breathing movements.

  • Fetal movement.

  • Fetal tone (extension and flexion of the extremities).

  • Measuring of the amniotic fluid volume.

Each of the five test parts is assigned a score of either 2 (normal) or 0 (abnormal). A combined score of 8 or 10 is normal, a score of 6 could go either way, and a score of 4 or less is abnormal.

No matter what the final score of the BPP is, if the amniotic fluid volume is 2 centimeters or less, further studies and evaluation of the baby should take place.

AFTER THE PROCEDURE

You may go home and resume your usual activities, or as directed by your caregiver.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's advice and recommendations.

  • Be aware of your baby's movements. Are they normal, less than usual or more than usual?

  • Make and keep the rest of your prenatal appointments.

SEEK MEDICAL CARE IF:

  • You develop a temperature of 100° F (37.8° C) or higher.

  • You have a bloody mucus discharge (bloody show).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You do not feel the baby moving.

  • You think the baby's movements have been less than usual or too many.

  • You develop uterine contractions.

  • You develop vaginal bleeding.

  • You develop abdominal pain.

  • You have leaking or a gush of fluid from the vagina.