The development of objective clinical methods for the detection of the fetus at risk for death or damage in utero did not begin in earnest until the past few decades. At its inception, objective fetal biophysical testing was limited to a single variable, the fetal heart rate, and antepartum testing methods, including the oxytocin challenge test and its variants such as the spontaneous contraction stress test (CST), were extrapolated from intrapartum observation.<sup>30Ray M., Freeman R.K., Pine S. Clinical experience with the oxytocin challenge test Am J Obstet Gynecol 1972 ;  114 : 1

Haga clic aquí para ir a la sección de Referencias, 34Schifrin B.S. The rational for antepartum fetal heart rate monitoring J Reprod Med 1979 ;  23 : 213

Haga clic aquí para ir a la sección de Referencias</sup> Almost from the outset of antepartum fetal heart rate monitoring, it was recognized that the record contained important information even in the absence of uterine contraction responses. Specifically, the association of fetal movement at heart rate acceleration, the basis of the nonstress test (NST), was recognized to be of prognostic value.<sup>9Freeman R.K., Anderson G., Dorchester W. A prospective multi-institutional study of antepartum fetal heart rate monitoring. I. Risk of perinatal morbidity and mortality according to antepartum fetal heart rate test results Am J Obstet Gynecol 1982 ;  143 : 771

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At around the same time, Dawes and colleagues<sup>6Dawes S., Fox H.E., Leduc B.M., y al. Respiratory movements and paradoxical sleep in the fetal lamb J Physiol (London) 1970 ;  210 : 47

Haga clic aquí para ir a la sección de Referencias</sup> were able to demonstrate an exquisite sensitivity of the fetal respiratory center to experimental hypoxemia in a series of elegant experiments in the chronic fetal lamb preparation, raising interest in the potential of this measurement in predicting human fetal compromise. By the mid 1990s, the revolutionary clinical tool of dynamic real-time B-mode ultrasound became available, and, through this method, observation of a broad range of dynamic fetal biophysical activities became a clinical reality. From the nascence of this new clinical testing modality, it was evident that observation of the presence or absence of breathing movements in the human fetus was as predictive as the NST,<sup>12Manning F.A. Fetal breathing movements as a reflection of fetal status Postgrad Med 1977 ;  6 : 116

Haga clic aquí para ir a la sección de Referencias</sup> was useful in the differentiation of true-positive and false-positive CST results,<sup>13Manning F.A., Platt L.D. Fetal breathing movements and the abnormal contraction stress tests Am J Obstet Gynecol 1979 ;  133 : 590

Haga clic aquí para ir a la sección de Referencias</sup> and, when combined with the heart rate test, yielded a better prediction of the risk of fetal death or compromise than any single test.<sup>14Manning F.A., Platt L.B., Sipos L., y al. Fetal breathing movements and the non-stress test in high risk pregnancies Am J Obstet Gynecol 1979 ;  179 : 135-511

Haga clic aquí para ir a la sección de Referencias</sup> Furthermore, it became evident that objective recording of gross body movements was predictive of fetal health and disease,<sup>15Manning F.A., Platt L.D. Fetal movements in human pregnancies in the third trimester Obstet Gynecol 1979 ;  54 : 699

Haga clic aquí para ir a la sección de Referencias</sup> and that when this information was combined with other biophysical variables, predicative accuracy was improved. The preliminary observations provided a first insight into a fundamental tenet of antepartum risk assessment, that is, the predictive accuracy of fetal testing methods improves as more fetal variables are considered. From these observations, the new concept of composite fetal assessment arose. The fetal biophysical profile scoring (BPS) method emerged from this rich clinical milieu as a means of integration of dynamic biophysical activities into a workable clinical format.<sup>16Manning F.A., Platt L.D., Sipos L. Antepartum fetal evaluation: Development of a fetal biophysical profile score Am J Obstet Gynecol 1980 ;  136 : 787

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This article reviews the clinical role of the fetal BPS in the prediction and prevention of perinatal mortality and perinatal morbidity as reflected by antenatal acidosis, immediate neonatal compromise, and long-term sequelae. Application of the testing method to discrete at-risk pregnancy categories is described.