Criteria for the biophysical profile test

Nonstress test: 2 points if reactive, defined as at least 2 episodes of FHR accelerations of at least 15 bpm and at least 15 seconds duration from onset to return associated with fetal movement.

Fetal breathing movements: 2 points if one or more episodes of rhythmic breathing movements of ≥30 seconds within a 30-minute observation period.

Fetal tone: 2 points if one or more episodes of extension of a fetal extremity or fetal spine with return to flexion.

Amniotic fluid volume: 2 points if a single deepest vertical pocket ≥2 cm is present. The horizontal dimension should be at least 1 cm.

Fetal movement: 2 points if three or more discrete body or limb movements within 30 minutes of observation. An episode of active continuous movement is counted as one movement.

Zero points are assigned for any criteria not met. A score of 10/10, 8/8 (nonstress test not done), or 8/10 (including +2 points for amniotic fluid) is a normal test result. A score of 6/10 (including +2 points for amniotic fluid) is an equivocal test result, as a significant possibility of developing fetal asphyxia cannot be excluded. A score of 6/10 or 8/10 with oligohydramnios (0 points for amniotic fluid) is an abnormal test, and further assessment and correlation with the clinical setting are indicated. A score of 0 to 4/10 is abnormal; the risk of fetal asphyxia within one week is high if there is no intervention, and delivery is usually indicated. Refer to UpToDate topic on the fetal biophysical profile for additional information.

FHR: fetal heart rate; bpm: beats per minute.

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