Common modalities for routine antepartum foetal monitoring: are they evidence-based?
Antepartum foetal monitoring is crucial for the detection of foetuses at risk so that timely intervention can improve the perinatal outcome. The evidence underlying the most common modalities of antepartum foetal monitoring used are appraised and presented in this article. Foetal movement chart should be used in high-risk pregnancies but not recommended routinely in low-risk pregnancies. Symphysis-fundal height measurement, being associated with low cost and ease of use, is a reasonable screening tool for foetal well-being. Third trimester ultrasonography is, thus far, the best modality available for the assessment of foetal growth, and can be used until a better modality for foetal growth assessment becomes available. Antepartum cardiotocography can be used to monitor foetal well-being in normal pregnancies beyond the estimated date of delivery but it probably serves little purpose prior to that. Well-designed controlled studies evaluating modalities for antepartum foetal monitoring are generally lacking. With the advance of medical science, more research should be focused on this aspect of obstetric care so that our practice can become more evidence-based.
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Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074. su_lin_lin@ hotmail.com
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D015148:Cardiotocography; D003955:Diagnostic Tests, Routine; D019317:Evidence-Based Medicine; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D005324:Fetal Movement / Q000502:physiology; D005333:Fetus / Q000502:physiology; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal