In extrauterine medicine, physicians have come to rely upon sampling of multiple biophysical variables as a means of differentiating states of well-being and compromise. This basic tenet of medicine is expressed by obtaining an Apgar score or some variant in the newborn and as a measure of vital signs in later life. Few, if any, decisions regarding well-being are ever based on a single-variable assessment and, conversely, definition of compromise is rarely based upon a single variable. Through the use of dynamic ultrasound imaging it now becomes possible to visualize the fetus and its biophysical responses in health and disease. Through such visualization it becomes possible to bring to bear some of the basic principles that sustain extrauterine medicine on the intrauterine patient, the fetus. Fetal biophysical profile scoring describes a method that encompasses this concept. The results obtained by application of this method are promising. We would argue that consideration of multiple fetal biophysical variables will, in most instances, yield superior results to single-variable monitoring alone. Hence we have abandoned antepartum fetal heart rate testing as the sole method of fetal risk assessment and used the tool only in conjunction with others of the many variables that may be monitored by dynamic ultrasound methods. This concept of multiple-variable analysis as the superior method for fetal assessment seems clear and well-justified. It is our opinion, however, that the concept of fetal bioprofile scoring may be more important than the method itself in its original description.(ABSTRACT TRUNCATED AT 250 WORDS)