BPP Flashcards
What are 2 Biophysical components?
Nonstress test and Fetal
What is involved in fetal BPP?
Breathing & movements (for 30 min), tone, qualitative amniotic fluid volume
How is BPP a scored?
2 for performance, 0 for no performance
What is the max BPP score in US parameters?
8
What is the first BPP component that becomes abnormal in the face of fetal hypoxia / academia?
Fetal heart rate reactivity and fetal breathing.
What is concurrently recorded by CTG (cardiotocography)?
Fetal heartbeat and uterine contractions
What does a non stress test record?
Fetal heart rate accelerations or deccelerations due to blood oxygen level changes resulting from uterine contractions
In a non stress test, what are normal and abnormal conditions?
Fetal heart rate acceleration is normal whereas deccelerations are abnormal
What is BPP?
Biophysical profile
What does a score 2 non stress test entail?
2 or more fetal heart rate accelerations of at least 15 beats per minute lasting at least 15 seconds and associated w/fetal movement in 40 minutes
What does a 0 score entail with non stress test?
No acceleration / less than 2 acc’s of fetal heart rate in 40 minutes
What does a score 2 entail with fetal breathing movements?
At least 1 30 second duration of fetal breathing in 30 minutes
What does a 0 score entail with fetal breathing movements?
Absence of breathing or for 30 second duration in 30 minutes
What does a Score 2 entail in fetal movements?
3 or more body/limb movements in 30 minutes (rolling trunk, face, hand, swallowing)
What does a Score 0 entail in fetal movements?
2 or less body movements in 30 minutes
What does a Score 2 entail in fetal tone?
1 or more extensions of a fetal extremity w/return to flexion or opening/closing of hand
What does a Score 0 entail in fetal tone?
Extremities in position of extension/partial flexion, spine in position of extension, fetal movement not followed by return to flexion
What does a Score 2 entail in qualitative amniotic fluid volume?
Largest vertical pocket of amniotic fluid greater/equal to 2 cm or AFI greater/equal 5
What does a Score 0 entail with qualitative amniotic fluid volume?
Largest vertical pocket of amniotic fluid less than 2 cm or AFI less than 4
What is the maximin score for a Score 2?
10
What are modified components of BPP?
NST / AFI
What plane do you scan fetal breathing movements?
Sagittal
What criterion is needed in AFI?
4 quadrants measured in AP
AFI 5⤴️ or largest pocket of 2 cm or more
What is BPP scoring for NST?
Reactive = 2, Nonreactive = 0
What is BPP scoring for sonographic observation maximum?
8
In BPP scoring, what is NST and sonographic maximum score?
10
In BPP scoring, what does less than 4 indicate?
Fetal compromise
What is the description for just - discernible movements?
Slow/small shifting movements fetal contour (0.5 to 2 seconds)
What is the description for startle movements?
Quick, generalized limb movements spreading to neck/trunk. Flexion/extension limbs of large size may be barely visible lasting about 1 sec
What is the description for general movements?
Whole body movement without distinctive pattern or sequence of body part movement
What is the description for hiccups?
Jerky contraction of diaphragm, abrupt displacement of diaphragm/thorax/abdomen
What is the description for breathing movements?
Inspiration consists of fluent, simultaneous movement of diaphragm (caudal direction) leading to movements of thorax (inward) and abdomen (outward)
What is the description for isolated arm/leg movements?
Rapid/slow movements involving extension, flexion, external/internal rotation or abduction/adduction of extremity without movements in other body parts
What is the description for isolated retroflexion of the head?
Displacement of the head can be large or small, large movements may cause overextension of fetal spine
What is the description of isolated rotation of the head?
Head may turn from a midline position position to one side and back often associated with hand-face contact
What is description for isolated anteflexion of the head?
Carried out at a slow velocity and occurs independently or with hand-face contact with observable sucking
What is the description for sucking/swallowing?
Rhythmic bursts of regular jaw opening and closing (once per second) and may be followed by swallowing (displacements of tongue/larynx)
What is the description for hand-face contact?
Hand slowly touches face/fingers frequently extend/flex
What is the description for flex?
Carried out at a slow speed consisting of forceful extension of back, retroflexion of head, and external rotation/elevation of arms
What is the description for yawning?
Prolonged widening of jaws, followed by quick closure often with retroflexion of head and sometimes elevation of arms
What is the description for rotation of fetus?
Rotation around sagittal/transverse axis, complex general moments change around transverse axis include alternating leg movements (may be with hip rotation) followed by trunk around longitudinal axis
