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Published on: June 29, 2013
Antepartum fetal testing: a critical appraisal
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York Medical College, Valhalla, New York, USA. fmanningob@aol.com
Current Opinion in Obstetrics & Gynecology
|May 9, 2009
Summary
Accurate antepartum fetal testing is crucial for identifying high-risk pregnancies. Composite testing of biophysical variables, including amniotic fluid volume measured by the maximal vertical pocket method, improves fetal risk assessment.
Area of Science:
- Perinatal Medicine
- Fetal Assessment
- High-Risk Pregnancy Monitoring
Background:
- Identifying fetuses at risk of in utero death or damage is vital.
- Antepartum fetal testing guides critical decisions in perinatal medicine.
- Fetal assessment methodologies are continuously evolving.
Purpose of the Study:
- To review the evolution of antepartum fetal testing.
- To examine the accuracy of various fetal assessment tests.
- To suggest future applications in fetal testing.
Main Methods:
- Review of existing literature on fetal testing evolution and accuracy.
- Examination of composite testing of fetal biophysical variables.
- Analysis of amniotic fluid volume measurement techniques.
Main Results:
- Composite testing effectively predicts fetal acidemia and risk of demise.
- Maximal vertical pocket method is recommended over amniotic fluid index for amniotic fluid volume assessment.
- Multispectral fetal testing, incorporating biophysical variables, fluid volume, and Doppler flow, is established.
Conclusions:
- Significant advancements have been made in identifying fetuses at risk.
- Multispectral fetal testing is a key development in managing high-risk pregnancies.
- The optimal frequency of testing for conditions like intrauterine growth restriction requires further investigation.