Antepartum Fetal Surveillance

The three most common methods used to evaluate fetal well-being in utero are the nonstress test, contraction stress test, and biophysical profile (Babbitt, 1996). Vibroacoustic stimulation and fetal movement counts are also useful adjunctive tools in the evaluation of fetal well-being.

The indications for antepartum fetal surveillance are multiple and reflect conditions that are associated with increased fetal morbidity and mortality (Smith-Levitin et al., 1997). Conditions that lead to fetal hypoxia, uteroplacental insufficiency, and death are all indications for increased fetal surveillance. There are no absolute protocols for increased fetal surveillance, but there are certain accepted practices for given maternal-fetal risks. For example, weekly antenatal testing beginning the 32nd week of gestation is often performed in women with low to moderate risk (e.g., gestational diabetes, chronic hypertension, mild preeclampsia). For women with higher risk of abnormal outcome, earlier and more frequent antenatal testing is indicated, requiring an individualized approach.

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