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A biophysical profile (BPP) is an assessment typically performed during pregnancy to evaluate the well-being of the fetus. It combines an ultrasound evaluation of fetal movement, fetal tone, fetal breathing movements, and amniotic fluid levels, along with a non-stress test to assess the fetal heart rate.

An abnormal score in a biophysical profile indicates potential concerns regarding fetal health. The scoring system for the BPP typically ranges from 0 to 10, with a score of 8 to 10 being considered normal. A score in the range of 5 to 7 is generally seen as "intermediate" or borderline, which might warrant further monitoring but does not necessarily reflect an immediate risk to the fetus.

In contrast, a score within the range of 0-4 is considered an abnormal score. This low scoring reflects significant concerns that require immediate attention, as it indicates potential fetal distress or complications that might necessitate further intervention, including possible delivery.

Thus, the identification of 0-4 as abnormal is based on the established guidelines and clinical protocols that define how healthcare providers respond to varying BPP scores to ensure the safety and health of the mother and fetus.