Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-26T01:15:05.207Z Has data issue: false hasContentIssue false

Chapter 9 - Antepartum Fetal Monitoring

from Section 2

Published online by Cambridge University Press:  19 November 2021

By
Jimmy Espinoza
Edited by
Olutoyin A. Olutoye
Olutoyin A. Olutoye
Affiliation:
Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois
Get access

Summary

Prenatal fetal monitoring allows for the detection of abnormal physiologic conditions in the fetus. The different available methods can detect abnormalities in utero-placental perfusion, as well as physiologic changes during and after in-utero fetal surgery. Basic antepartum fetal monitoring in viable fetuses has advanced over the years and now involves not only the nonstress test but more advanced methods which also take into account the ultrasound findings. Comprehension of the different fetal heart rate tracings allow for rapid intervention where necessary. Unfortunately, while many modes of surveillance exist, no single method can accurately identify a fetus that will progress to being stillbirth.

Keywords

nonstress testsurveillancefetusbiophysical profileultrasoundamniotic fluid indexdeep vertical pockettracinghypoxiaacidosis
Type
Chapter
Information
Anesthesia for Maternal-Fetal Surgery
Concepts and Clinical Practice
 , pp. 119 - 136
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Practice bulletin no. 145: antepartum fetal surveillance. Obstet Gynecol. 2014;124:182–192.Google Scholar
Manning, FA, Platt, LD. Maternal hypoxemia and fetal breathing movements. Obstet Gynecol. 1979;53:758–760.Google ScholarPubMed
Boddy, K, Dawes, GS, Fisher, R, et al. Foetal respiratory movements, electrocortical and cardiovascular responses to hypoxaemia and hypercapnia in sheep. J Physiol. 1974;243:599–618.Google Scholar
Natale, R, Clewlow, F, Dawes, GS. Measurement of fetal forelimb movements in the lamb in utero. Am J Obstet Gynecol. 1981;140:545–551.Google Scholar
Murata, Y, Martin, CB, Jr., Ikenoue, T, et al. Fetal heart rate accelerations and late decelerations during the course of intrauterine death in chronically catheterized rhesus monkeys. Am J Obstet Gynecol. 1982;144:218–223.Google Scholar
Weiner, CP, Sipes, SL, Wenstrom, K. The effect of fetal age upon normal fetal laboratory values and venous pressure. Obstet Gynecol. 1992;79:713–718.Google Scholar
Manning, FA, Snijders, R, Harman, CR, et al. Fetal biophysical profile score. VI. Correlation with antepartum umbilical venous fetal pH. Am J Obstet Gynecol. 1993;169:755–763.CrossRefGoogle ScholarPubMed
Freeman, RK, Anderson, G, Dorchester, W. A prospective multi-institutional study of antepartum fetal heart rate monitoring. II. Contraction stress test versus nonstress test for primary surveillance. Am J Obstet Gynecol. 1982;143:778–781.CrossRefGoogle ScholarPubMed
Boehm, FH, Salyer, S, Shah, DM, Vaughn, WK. Improved outcome of twice weekly nonstress testing. Obstet Gynecol. 1986;67:566–568.Google Scholar
Manning, FA, Morrison, I, Harman, CR, et al. Fetal assessment based on fetal biophysical profile scoring: experience in 19,221 referred high-risk pregnancies. II. An analysis of false-negative fetal deaths. Am J Obstet Gynecol. 1987;157:880–884.CrossRefGoogle Scholar
Miller, DA, Rabello, YA, Paul, RH. The modified biophysical profile: antepartum testing in the 1990s. Am J Obstet Gynecol. 1996;174:812–817.CrossRefGoogle ScholarPubMed
Thacker, SB, Berkelman, RL. Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet Gynecol Surv. 1986;41:121–141.Google Scholar
Pearson, JF, Weaver, JB. Fetal activity and fetal wellbeing: an evaluation. Br Med J. 1976;1:1305–1307.Google Scholar
Andersen, HF, Johnson, TR, Jr., Flora, JD, Jr., Barclay, ML. Gestational age assessment. II. Prediction from combined clinical observations. Am J Obstet Gynecol. 1981;140:770–774.Google Scholar
Neldam, S. Fetal movements as an indicator of fetal well-being. Dan Med Bull. 1983;30:274–278.Google ScholarPubMed
O’Neill, E, Thorp, J. Antepartum evaluation of the fetus and fetal well being. Clin Obstet Gynecol. 2012;55:722–730.Google Scholar
Patrick, J, Campbell, K, Carmichael, L, et al. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. Am J Obstet Gynecol. 1982;142:363–371.Google Scholar
Moore, TR, Piacquadio, K. A prospective evaluation of fetal movement screening to reduce the incidence of antepartum fetal death. Am J Obstet Gynecol. 1989;160:1075–1080.Google Scholar
Grant, A, Elbourne, D, Valentin, L, Alexander, S. Routine formal fetal movement counting and risk of antepartum late death in normally formed singletons. Lancet. 1989;2:345–349.CrossRefGoogle ScholarPubMed
Mangesi, L, Hofmeyr, GJ, Smith, V, Smyth, RM. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2015;CD004909.Google Scholar
Evertson, LR, Gauthier, RJ, Schifrin, BS, Paul, RH. Antepartum fetal heart rate testing. I. Evolution of the nonstress test. Am J Obstet Gynecol. 1979;133:29–33.CrossRefGoogle ScholarPubMed
ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009;114:192–202.Google Scholar
Macones, GA, Hankins, GD, Spong, CY, et al. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. J Obstet Gynecol Neonatal Nurs. 2008;37:510–515.Google Scholar
Tan, KH, Smyth, RM, Wei, X. Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing. Cochrane Database Syst Rev. 2013;CD002963.Google Scholar
Wheeler, T, Murrills, A. Patterns of fetal heart rate during normal pregnancy. Br J Obstet Gynaecol. 1978;85:18–27.CrossRefGoogle ScholarPubMed
Bishop, EH. Fetal acceleration test. Am J Obstet Gynecol. 1981;141:905–909.Google Scholar
Druzin, ML, Gratacos, J, Keegan, KA, Paul, RH. Antepartum fetal heart rate testing. VII. The significance of fetal bradycardia. Am J Obstet Gynecol. 1981;139:194–198.CrossRefGoogle ScholarPubMed
Lavin, JP, Jr., Miodovnik, M, Barden, TP. Relationship of nonstress test reactivity and gestational age. Obstet Gynecol. 1984;63:338–344.Google Scholar
Park, MI, Hwang, JH, Cha, KJ, et al. Computerized analysis of fetal heart rate parameters by gestational age. Int J Gynaecol Obstet. 2001;74:157–164.CrossRefGoogle ScholarPubMed
Sadovsky, G, Nicolaides, KH. Reference ranges for fetal heart rate patterns in normoxaemic nonanaemic fetuses. Fetal Ther. 1989;4:61–68.Google Scholar
Hatjis, CG, Meis, PJ. Sinusoidal fetal heart rate pattern associated with butorphanol administration. Obstet Gynecol. 1986;67:377–380.Google Scholar
Grivell, RM, Alfirevic, Z, Gyte, GM, Devane, D. Antenatal cardiotocography for fetal assessment. Cochrane Database Syst Rev. 2012;12:CD007863.CrossRefGoogle ScholarPubMed
ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999 (replaces Technical Bulletin Number 188, January 1994). Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000;68:175–185.Google Scholar
Vintzileos, AM, Gaffney, SE, Salinger, LM, et al. The relationship between fetal biophysical profile and cord pH in patients undergoing cesarean section before the onset of labor. Obstet Gynecol. 1987;70:196–201.Google Scholar
Manning, FA, Bondaji, N, Harman, CR, et al. Fetal assessment based on fetal biophysical profile scoring. VIII. The incidence of cerebral palsy in tested and untested perinates. Am J Obstet Gynecol. 1998;178:696–706.Google Scholar
Chamberlain, PF, Manning, FA, Morrison, I, et al. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol. 1984;150:245–249.Google Scholar
Manning, FA, Harman, CR, Morrison, I, et al. Fetal assessment based on fetal biophysical profile scoring. IV. An analysis of perinatal morbidity and mortality. Am J Obstet Gynecol. 1990;162:703–709.Google Scholar
Nabhan, AF, Abdelmoula, YA. Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome. Cochrane Database Syst Rev. 2008;CD006593.Google Scholar
Vintzileos, AM, Gaffney, SE, Salinger, LM, et al. The relationships among the fetal biophysical profile, umbilical cord pH, and Apgar scores. Am J Obstet Gynecol. 1987;157:627–31.Google Scholar
Vintzileos, AM, Campbell, WA, Nochimson, DJ, Weinbaum, PJ. The use and misuse of the fetal biophysical profile. Am J Obstet Gynecol. 1987;156:527–533.Google Scholar
Vintzileos, AM, Fleming, AD, Scorza, WE, et al. Relationship between fetal biophysical activities and umbilical cord blood gas values. Am J Obstet Gynecol. 1991;165:707–713.Google Scholar
Martin, CB, Jr. Normal fetal physiology and behavior, and adaptive responses with hypoxemia. Semin Perinatol. 2008;32:239–242.Google Scholar
Dayal, AK, Manning, FA, Berck, DJ, et al. Fetal death after normal biophysical profile score: An eighteen-year experience. Am J Obstet Gynecol. 1999;181:1231–1236.Google Scholar
Manning, FA. Fetal biophysical profile. Obstet Gynecol Clin North Am. 1999;26:557–577,v.CrossRefGoogle ScholarPubMed
Clark, SL, Sabey, P, Jolley, K. Nonstress testing with acoustic stimulation and amniotic fluid volume assessment: 5973 tests without unexpected fetal death. Am J Obstet Gynecol. 1989;160:694–697.CrossRefGoogle ScholarPubMed
Rutherford, SE, Phelan, JP, Smith, CV, Jacobs, N. The four-quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. Obstet Gynecol. 1987;70:353–356.Google Scholar
Manning, FA, Morrison, I, Lange, IR, et al. Fetal assessment based on fetal biophysical profile scoring: experience in 12,620 referred high-risk pregnancies. I. Perinatal mortality by frequency and etiology. Am J Obstet Gynecol. 1985;151:343–350.Google Scholar
Manning, FA, Menticoglou, S, Harman, CR, et al. Antepartum fetal risk assessment: the role of the fetal biophysical profile score. Baillieres Clin Obstet Gynaecol. 1987;1:55–72.Google Scholar
Manning, FA. Antepartum fetal surveillance. Curr Opin Obstet Gynecol. 1995;7:146–149.Google Scholar
Seravalli, V, Baschat, AA. A uniform management approach to optimize outcome in fetal growth restriction. Obstet Gynecol Clin North Am. 2015;42:275–288.Google Scholar
Alfirevic, Z, Stampalija, T, Gyte, GM. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database Syst Rev. 2010;CD007529.Google Scholar
Berkley, E, Chauhan, SP, Abuhamad, A. Doppler assessment of the fetus with intrauterine growth restriction. Am J Obstet Gynecol. 2012;206:300–308.Google Scholar
DeVore, GR. The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses. Am J Obstet Gynecol. 2015;213:5–15.Google Scholar
Dunn, L, Sherrell, H, Review, Kumar S. Systematic review of the utility of the fetal cerebroplacental ratio measured at term for the prediction of adverse perinatal outcome. Placenta. 2017;54:68–75.CrossRefGoogle ScholarPubMed
Khalil, A, Morales-Rosello, J, Townsend, R, et al. Value of third-trimester cerebroplacental ratio and uterine artery Doppler indices as predictors of stillbirth and perinatal loss. Ultrasound Obstet Gynecol. 2016;47:74–80.Google Scholar
Seravalli, V, Miller, JL, Block-Abraham, D, Baschat, AA. Ductus venosus Doppler in the assessment of fetal cardiovascular health: an updated practical approach. Acta Obstet Gynecol Scand. 2016;95:635–644.CrossRefGoogle ScholarPubMed
Baschat, AA, Harman, CR. Antenatal assessment of the growth restricted fetus. Curr Opin Obstet Gynecol. 2001;13:161–168.Google Scholar
Gudmundsson, S, Tulzer, G, Huhta, JC, Marsal, K. Venous Doppler in the fetus with absent end-diastolic flow in the umbilical artery. Ultrasound Obstet Gynecol. 1996;7:262–267.Google Scholar
Hofstaetter, C, Dubiel, M, Gudmundsson, S. Two types of umbilical venous pulsations and outcome of high-risk pregnancy. Early Hum Dev. 2001;61:111–117.Google Scholar
Erskine, RL, Ritchie, JW. Umbilical artery blood flow characteristics in normal and growth-retarded fetuses. Br J Obstet Gynaecol. 1985;92:605–610.Google Scholar
Giles, WB, Trudinger, BJ, Baird, PJ. Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation. Br J Obstet Gynaecol. 1985;92:31–38.Google Scholar
Reuwer, PJ, Bruinse, HW, Stoutenbeek, P, Haspels, AA. Doppler assessment of the fetoplacental circulation in normal and growth-retarded fetuses. Eur J Obstet Gynecol Reprod Biol. 1984;18:199–205.Google Scholar
Devoe, LD, Gardner, P, Dear, C, Faircloth, D. The significance of increasing umbilical artery systolic-diastolic ratios in third-trimester pregnancy. Obstet Gynecol. 1992;80:684–687.Google Scholar
Giles, W, Bisits, A. Clinical use of Doppler ultrasound in pregnancy: information from six randomised trials. Fetal Diagn Ther. 1993;8:247–255.Google Scholar
Rychik, J, Tian, Z, Cohen, MS, et al. Acute cardiovascular effects of fetal surgery in the human. Circulation. 2004;110:1549–1556.Google Scholar
Howley, L, Wood, C, Patel, SS, et al. Flow patterns in the ductus arteriosus during open fetal myelomeningocele repair. Prenat Diagn. 2015;35:564–570.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×