Umbilical artery Doppler velocimetry seems to benefit only pregnancies complicated by intrauterine growth restriction. Recent, normal antepartum fetal test results should not preclude the use of intrapartum fetal monitoring.
If repetitive late decelerations are observed, cesarean delivery generally is indicated. In the absence of obstetric contraindications, delivery of the fetus with an abnormal test result often may be attempted by induction of labor with continuous monitoring of the fetal heart rate and contractions. Oligohydramnios, defined as no ultrasonographically measurable vertical pocket of amniotic fluid greater than 2 cm or an amniotic fluid index of 5 cm or less, requires (depending on the degree of oligohydramnios, the gestational age and the maternal clinical condition) delivery, or close maternal or fetal surveillance. Subsequent management should then be predicated on the results of the contraction stress test or biophysical profile, the gestational age, the degree of oligohydramnios (if assessed) and the maternal condition.
#FETAL HEART DOPPLER RENTALS FULL#
Any significant deterioration in fetal activity requires fetal reevaluation, regardless of the amount of time that has elapsed since the last test.Īn abnormal nonstress test or modified biophysical profile usually should be further evaluated by a contraction stress test or a full biophysical profile.
When the clinical condition that prompted testing persists, a reassuring test should be repeated weekly or, depending on the test used and the presence of certain high-risk conditions, twice weekly until delivery.
In pregnancies with multiple or particularly worrisome high-risk conditions, testing may be initiated as early as 26 to 28 weeks of gestation. Initiation of testing at 32 to 34 weeks of gestation is appropriate for most pregnancies that are at increased risk of stillbirth. Women at high risk for stillbirth should undergo antepartum fetal surveillance using the nonstress test, contraction stress test, biophysical profile or modified biophysical profile.
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