ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999 (replaces Technical Bulletin Number 188, January 1994). Clinical management guidelines for obstetrician-gynecologists.

The goal of antepartum fetal surveillance is to prevent fetal death. Antepartum fetal surveillance techniques based on assessment of fetal heart rate patterns have been in clinical use for almost three decades. More recently, real-time ultrasonography and Doppler velocimetry have been used to evaluate fetal well-being. Antepartum fetal surveillance techniques are now routinely used to assess the risk of fetal death in pregnancies complicated by preexisting maternal conditions (e.g., type 1 diabetes mellitus) as well as those in which complications have developed (e.g., intrauterine growth restriction). This document will review the current indications for and techniques of antepartum fetal surveillance and outline management guidelines for antepartum fetal surveillance, consistent with the best contemporary scientific evidence.