Epidemiology of antepartum fetal testing

Advances in perinatal and neonatal health care over the past few decades have resulted in a substantial reduction in perinatal mortality. Some of this improvement has been attributed to antepartum fetal surveillance techniques. The primary objective of antepartum fetal surveillance techniques is to avoid fetal deaths. An ideal secondary objective is to avoid neonatal complications related to intrauterine asphyxia. In this article, some of the difficulties in evaluating existing antepartum fetal surveillance techniques are highlighted. Some of the epidemiological methods for evaluating a screening test are reviewed and their importance discussed with reference to fetal testing procedures. Lastly, the possibility of considering indication-specific fetal testing to improve perinatal morbidity is examined.