Fetal Monitoring Services in Brooklyn
The main goal of antepartum fetal surveillance is to identify the fetus that will benefit from early intervention, such as in utero resuscitation or delivery, and thereby prevent fetal death or neurologic injury.
- Antepartum testing is based on the premise that the fetus responds to hypoxemia with a detectable sequence of biophysical changes.
- Antepartum fetal surveillance has had an established role in obstetrical practice since the 1970s, although its ability to improve pregnancy outcome has not been evaluated by large, well-designed randomized trials.
- Antepartum fetal testing is indicated in “pregnancies in which the risk of antepartum fetal demise is increased.
- Techniques for assessment of fetal well-being (nonstress test, contraction stress test, biophysical profile, modified biophysical profile) are described in the table.
- The optimal choice of technique(s) for fetal assessment has not been determined and depends on multiple factors, including gestational age, availability, desire for fetal biometry or follow-up of a congenital anomaly, ability to monitor the fetal heart rate, and cost. The best evidence supports umbilical artery Doppler assessment for monitoring fetuses with early-onset growth restriction due to uteroplacental insufficiency, given its proven efficacy in reducing perinatal death in this setting when used with standard fetal testing (nonstress test, biophysical profile score) and appropriate intervention. It has only modest ability to predict fetal compromise in other high-risk pregnancies.
- Testing is typically performed weekly, but the frequency is generally increased if there is a change in pregnancy status or in clinical settings considered to be very high risk.
- An abnormal test result is generally followed by additional testing with a different test, given the high rate of false-positive results. The clinical setting also needs to be considered. If a temporary maternal condition may account for the abnormal test result, prompt treatment of the maternal condition may also improve fetal oxygenation and lead to a normal test result on subsequent testing. In chronic conditions, clinical judgment guides management and needs to consider case specific factors.