Version June 2024
| BPP score | Amniotic fluid volume | Interpretation | Next steps |
| 10/10, 8/8, or 8/10 | Normal | Normal score | Repeat once or twice weekly until delivery as long as the indication for testing persists and the condition appears to be stable |
| 8/10 | Oligohydramnios | Rare score in the absence of membrane rupture or fetal urinary tract anomaly, but may occur in postterm pregnancies and pregnancies complicated by fetal growth restriction | Management of oligohydramnios depends on the clinical scenario. |
| 6/10 | Normal | Equivocal | Repeat test within 24 hours. In about two-thirds of cases, a repeat BPP will yield a normal result. Management is based upon the repeat result. If the BPP score reverts to normal, then continued serial surveillance is appropriate. If the BPP of 6/10 persists, delivery may be indicated if the gestational age is sufficiently advanced to sustain extrauterine life; management of these cases needs to be individualized. |
| 6/10 | Oligohydramnios | Concerning because risk of fetal death is increased (89 per 1000 within seven days) | Repeat test within 24 hours. Management is based upon the repeat result. If the BPP of 6/10 persists, delivery may be indicated if the gestational age is sufficiently advanced to sustain extrauterine life; management of these cases needs to be individualized. If the BPP score reverts to normal (8/10), then management of oligohydramnios depends on the clinical scenario. Continued clinical surveillance is appropriate. |
| 6/8 | – | Not interpretable | A nonstress test always needs to be performed to determine whether this interim score will change to 6/10 or 8/10. Interpretation and management depend on this final score. |
| 4/10 | Normal | A score of 4/10 with normal amniotic fluid is usually an indication for delivery if the gestational age is sufficiently advanced to sustain extrauterine life. Before 34 weeks, it is reasonable to administer a course of antenatal corticosteroids and repeat the BPP within 24 hours of the previous BPP; delivery at that time is indicated if the repeat BPP is 6/10 or less. | |
| 4/10 | Oligohydramnios | In a fetus with intact membranes and a functional patent genitourinary tract, a score of 4/10 with oligohydramnios is usually an indication for delivery if the gestational age is sufficiently advanced to sustain extrauterine life. Before 34 weeks of gestation, it is reasonable to administer a course of antenatal corticosteroids and wait 24 to 48 hours before delivering the fetus, as long as the fetus remains under intense and often continuous FHR surveillance. In the setting of membrane rupture or congenital anomalies that reduce urination, management must be individualized. | |
| 2/10 | – | High risk for fetal demise | Virtually always an indication for prompt delivery if the gestational age is sufficiently advanced to sustain extrauterine life. In the extremely immature fetus (<28 weeks) with this score, extending the testing time or repeat testing over a short interval (four to six hours) is a consideration. A sustained or persistent BPP of 2/10 is virtually always an indication for prompt delivery if the gestational age is sufficiently advanced to sustain extrauterine life. |
| 0/10 | – | High risk for fetal demise | Virtually always an indication for prompt delivery if the gestational age is sufficiently advanced to sustain extrauterine life |
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