Routine antenatal fetal assessment

The purpose of any form of antenatal fetal surveillance must be to recognize accurately fetal and environmental conditions which adversely influence perinatal mortality and morbidity at an early enough stage to use whatever corrective measures may be available. At booking, risk assessment identifies the woman with social or medical predictors of poor pregnancy outcome from the woman in good health who should have a successful pregnancy. Thus the high-risk patient is a woman in whom the chances of an adverse outcome to herself and/or the baby are greater than the incidence of that outcome in the general obstetric population. The corollary of this definition however, is that the “low-risk” obstetric patient still has the chance of an adverse outcome but the incidence of that outcome is that of the general obstetric population. In the absence of information relating specifically to the fetus, this maternal data is then extrapolated to predict the high or low risk fetus. This system however, does not predict the high risk normally formed stillbirth who is often, but not always, smaller than the gestational age-matched liveborn infant but who is commonly delivered of the low risk woman.