Antepartum fetal assessment in hypertensive pregnancies

Antepartum fetal assessment in hypertensive pregnancies helps to prevent perinatal morbidity and mortality. The pathophysiology of chronic maternal hypertension often leads to placental insufficiency and fetal growth retardation. Current testing schemes include serial ultrasonographic assessment of fetal growth, placental morphology, and amniotic fluid volume; fetal heart rate testing using either non-stress or contraction stress methods; multiple parameter biophysical profile; and Doppler flow velocimetry of fetal umbilical and maternal uterine arteries. The values of individual and combined testing approaches are evaluated and an integrated scheme for fetal management, illustrated by case examples, is presented.