Common Issues in Prenatal Care: Antepartum Fetal Surveillance

Patients at increased risk of stillbirth should be assessed with antepartum fetal surveillance (AFS) tests at regular intervals. In general, AFS should begin at the gestational age at which delivery would be considered. Most surveillance tests are performed weekly, but more frequent testing should be considered for patients with high-risk conditions. AFS tests include fetal movement monitoring, nonstress test, contraction stress test, biophysical profile, and modified biophysical profile. Umbilical artery Doppler velocimetry is used in the setting of fetal growth restriction. Abnormal test results should prompt additional assessment and consideration of delivery. Normal test results can provide reassurance about fetal well-being, but cannot predict the likelihood of acute incidents, such as placental abruption and umbilical cord infarction.