Antenatal fetal surveillance has stood the test of time with regard to the goal of preventing stillbirth in the fetus at risk based on indications for testing. As such, the additional cost for testing in the appropriate setting appears to have benefit. However, clinicians should be reminded that the least costly antenatal surveillance modality is maternal fetal movement assessment as a test for well-being in low- and high-risk women, even if its effectiveness in preventing stillbirth is uncertain.

Fetal kick counting in current antenatal clinical care appears to be underutilized and clinicians should be reminded to educate women about this modality in antenatal care.

The goal of antepartum fetal surveillance is to prevent fetal death. Antepartum fetal surveillance techniques based on assessment of fetal heart rate (FHR) patterns have been in clinical use for almost four decades and are used along with real-time ultrasonography and umbilical artery Doppler velocimetry to evaluate fetal well-being. Antepartum fetal surveillance techniques are routinely used to assess the risk of fetal death in pregnancies complicated by preexisting maternal conditions (eg, diabetes mellitus) as well as those in which complications have developed (eg, fetal growth restriction). The purpose of this document is to provide a review of the current indications for and techniques of antepartum fetal surveillance and outline management guidelines for antepartum fetal surveillance that are consistent with the best scientific evidence.

Source: Contemporary Ob Gyn

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