What is a biophysical profile?

A biophysical profile is a test that is sometimes used during the third trimester of pregnancy. It is often done if there is a question about the baby’s health. This may be because of other test results or certain pregnancy symptoms, or because your pregnancy is high risk.

The biophysical profile combines two tests to check your unborn baby’s overall health: a nonstress test and an ultrasound.

• Nonstress test. This test checks your baby’s heart rate and your contractions. This is done through devices (sensors) that are strapped to belts wrapped around your belly. Nonstress means that nothing is done to cause your baby stress during the test.

• Ultrasound evaluation. This is just like the ultrasounds done at other times during pregnancy. A healthcare provider will use an ultrasound machine to see into your uterus and check your unborn baby.

During the biophysical profile, your provider is looking at five main areas to check your baby’s health: body movements, muscle tone, breathing movements, amniotic fluid, and heartbeat.

Each of these five areas is given a score of either 0 (abnormal) or 2 (normal). These scores are then added up for a total score ranging from 0 to 10. In general, a score of 8 or 10 is normal, while 6 is borderline. Below 6 is a sign of possible problems. More tests may be needed.

The test results can also help your healthcare provider decide if your baby might need to be born early.

Why might I need a biophysical profile?

A biophysical profile is often done if there is a concern about your baby’s health. For instance, it might be done if there is decreased fetal movement or a fetal growth problem, or your pregnancy goes past 42 weeks. But if your healthcare provider suggests a biophysical profile, it doesn’t mean anything is wrong with your baby.

Your provider may have other reasons to recommend a biophysical profile.

What are the risks of a biophysical profile?

The biophysical profile is an easy, safe, and painless procedure. For the nonstress test, the provider wraps two belts around your belly. Devices (sensors) attached to these belts will check your baby’s heart rate and your contractions. For the ultrasound, the provider will put a gel on your belly. Then they will move an ultrasound wand (transducer) and press into the gel. This will give a view into your uterus. The images can be seen on a screen.

This test poses very little risk to you and your baby. Some concern has been raised about doing ultrasounds over a long period of time. But having an ultrasound now and then doesn’t seem to be a risk to your baby.

You may have other risks depending on your specific condition. Be sure to talk with your provider about any concerns you have before the test.

How do I get ready for a biophysical profile?

You don’t have to do anything to get ready for a biophysical profile. The test will likely be done in your healthcare provider’s office. No hospital stay is needed. A biophysical profile is typically done after 32 to 34 weeks of pregnancy.

What happens during a biophysical profile?

The biophysical profile is often done in a private room at your healthcare provider's office.

Generally, a biophysical profile follows this process:

1. Your healthcare provider will explain the test to you. Ask them any questions you have about the test.

2. You may be asked to undress and put on a hospital gown.

3. You will lie down on an exam table or bed.

4. The nonstress test is often done first. The provider puts a belt with a device (sensor) attached around your belly. The sensor checks your baby’s heart rate. This will be displayed on a screen.

5. The provider puts a second belt and sensor around you right next to the first. This sensor measures your contractions. Even though labor may still be a few weeks off, contractions are normal at this point in your pregnancy. This part of the test often lasts 20 to 30 minutes.

6. If your baby doesn’t move during the test, don’t panic. The baby might be asleep. If this happens, a nurse may try to wake the baby with a buzzer.

7. The belts and devices are then taken off. This part of the test is over.

8. The ultrasound part of the test may take up to 1 hour. Your healthcare provider will put warmed ultrasound gel on your bare belly.

9. The provider will press a small, handheld wand (transducer) into the gel and against your belly. Images of your baby in your uterus will be shown on a screen.

10. The provider will look at your baby’s breathing movements, body movement, and muscle tone. They will also measure the amniotic fluid around the baby.

11. When this part of the exam is complete, the provider will wipe the ultrasound gel off your belly. You can get dressed.

What happens after a biophysical profile?

Your healthcare provider will score your baby’s health based on the results of the five areas checked: body movements, muscle tone, breathing movements, amniotic fluid, and heartbeat.

You will talk with your provider about what the score means. If the score is lower than your provider had hoped, they might suggest that you schedule your baby’s delivery earlier than expected. This may mean inducing labor. Or you might deliver by C-section (cesarean section).

If your baby scores in the normal range, your provider may decide that everything is OK. You can go on with your pregnancy as usual. You can wait for labor to start on its own. You may be asked to repeat this test in a week or so.

There are no special precautions to take after a biophysical profile.

Your healthcare provider may give you other instructions, depending on your own situation.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure