Biophysical Profile (BPP) Score Calculator

How it works

BPP = NST + breathing + movement + tone + amniotic fluid, each 2 (normal) or 0 (abnormal) · 8–10 normal (with normal fluid), 6 equivocal, 4 or less abnormal · without NST: 8/8 normal

The biophysical profile, introduced by Manning in 1980, combines a non-stress test with four ultrasound observations over up to 30 minutes: fetal breathing movements, gross body movements, tone and amniotic fluid volume. Each normal finding scores 2 and each abnormal one 0. ACOG considers 8 or 10 out of 10 normal, 6 equivocal and 4 or less abnormal; low amniotic fluid (deepest pocket of 2 cm or less) needs further evaluation even with an otherwise normal score. When all four ultrasound items are normal, the non-stress test can be omitted and 8/8 is reassuring.

Worked example

A reactive non-stress test (2), breathing movements present (2), 3 or more body movements (2), normal tone (2) and a deepest fluid pocket over 2 cm (2): BPP = 2 + 2 + 2 + 2 + 2 = 10 / 10, which is Normal — continue routine testing as scheduled.

Sources: ACOG Practice Bulletin No. 229: Antepartum fetal surveillance (2021) · Manning FA, Platt LD, Sipos L (1980) Antepartum fetal evaluation: development of a fetal biophysical profile. Am J Obstet Gynecol 136(6):787–795

Frequently asked questions