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14 - Antepartum evaluation of fetal well-being

from Section 2 - Pregnancy, labor, and delivery complications causing brain injury

Published online by Cambridge University Press:  12 January 2010

By
Deirdre J. Lyell  and
Maurice L. Druzin
Edited by
David K. Stevenson ,
William E. Benitz ,
Philip Sunshine ,
Susan R. Hintz  and
Maurice L. Druzin
David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

In the USA, nearly 50% of all perinatal death occurs prior to birth. While fetal death from acute events such as cord accidents cannot be predicted, identifying, testing, and intervening for the fetus at risk for chronic in utero compromise may prevent neonatal and infant morbidity. This chapter discusses the antenatal assessment of fetal well-being.

An antepartum fetal test should reduce perinatal morbidity and mortality, and reassure parents. The test of choice depends on gestational age. When a fetus at risk for acidosis and asphyxia has reached viability, one of several tests may be employed for screening, including the non-stress test (NST), the contraction stress test (CST), fetal movement monitoring, the biophysical profile (BPP), and Doppler ultrasound. The sensitivity of these tests is generally high, while the specificity is highly variable. Diagnostic ultrasound and prenatal diagnostic procedures such as chorionic villus sampling (CVS) or amniocentesis are the most common tests performed during the early stages of pregnancy to identify chromosomal or major fetal anomalies.

The purpose of this chapter is to discuss common antepartum screening tests, including a description of each test, its indication, and its accuracy.

Type
Chapter
Information
Fetal and Neonatal Brain Injury , pp. 163 - 173
Publisher: Cambridge University Press
Print publication year: 2009

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