Antenatal fetal assessment: an overview.
In the past two decades there have been dramatic changes in antenatal fetal assessment. As experience has been gained with new modalities, it has been possible to further decrease perinatal morbidity and mortality by modifying the indications and the frequency of testing, as well as the time of initiation. More antepartum assessment is performed today than ever before with the advent of new procedures. With the increasing complexity of multiple modalities and confounding risk factors it has become necessary to individualize the management of each high-risk pregnancy. The clinician should attempt to identify which test or group of tests will insure the lowest perinatal mortality for a given risk factor. The specific test(s) utilized will depend on the population, the expertise of the personnel administering the test, and the manpower and equipment available. Antenatal fetal assessment is usually not performed unless one is prepared to modify obstetric management or expedite delivery when significant abnormalities are identified. The risks of delivery (maternal and neonatal) must then be weighed against the potential adverse effects of continuing the pregnancy. It should be recognized that there is no single "best test" for all clinical situations. It is important for the practicing physician to keep abreast of new developments in antenatal assessment and to be aware of recommended modifications in older applications.
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson.
J F
JF
McCaul
J C
JC
Morrison
D000013:Congenital Abnormalities / Q000175:diagnosis; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D005324:Fetal Movement; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*