If NST is non-reactive, what is the commonly planned next evaluation?

• A. Biophysical profile (BPP)
• B. Ultrasound of abdomen
• C. Amniocentesis
• D. Maternal blood test

Answer: (A)

When a non-reactive NST occurs, you can’t rely on heart-rate accelerations alone to judge fetal well-being. The usual next step is a biophysical profile, because it combines ultrasound assessment of fetal function with the NST to give a fuller picture of oxygenation and reserve. The BPP looks at five components—fetal breathing movements, gross body movements, fetal tone, amniotic fluid volume, and the NST itself. Each component contributes to a total score that helps distinguish truly compromised fetuses from those that are simply temporarily inactive. A normal score suggests the fetus is doing well, while a low score flags potential distress and may lead to closer monitoring or delivery decisions. This approach is more informative than ultrasound alone (which checks anatomy), maternal blood tests (which don’t directly measure fetal well-being), or amniocentesis (which is invasive and not indicated here). Contraction stress testing is another option in some cases, but the biophysical profile is the standard next evaluation in this scenario.