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Williams Obstetrics, 23e
| Section III. Antepartum > |
Chapter 15. Antepartum Assessment
Sections: Antepartum Assessment: Introduction, Fetal Movements, Fetal Breathing, Contraction Stress Testing, Nonstress Tests, Acoustic Stimulation Tests, Biophysical Profile, Amnionic Fluid Volume, Doppler Velocimetry, Current Antenatal Testing Recommendations, References.
Topics Discussed: fetal status, antepartum.
Excerpt:"According to the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics (2007), the goals of antepartum fetal surveillance include prevention of fetal death and avoidance of unnecessary interventions. Current techniques employed to forecast fetal well-being focus on fetal physical activities, including heart rate, movement, breathing, and amnionic fluid production. In most cases, a negative, that is, normal test result is highly reassuring, because fetal deaths within 1 week of a normal test are rare. Indeed, negative-predictive values—a true negative test—for most of the tests described are 99.8 percent or higher. In contrast, estimates of the positive-predictive values—a true positive test—for abnormal test results are low and range between 10 and 40 percent. Importantly, the widespread use of antepartum fetal surveillance is primarily based on circumstantial evidence because there have been no definitive randomized clinical trials...."
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