Antepartum fetal heart rate monitoring. State of the art.

1. AFHRT remains one of the most widely used methods of assessing fetal condition. 2. The actual types of tests used as primary surveillance tests are unimportant. Both the NST and CST have been successfully used. 3. The clinician should adopt a scheme in which they have all the data necessary to determine whether this will fit in with their practice. 4. Characteristics other than reactivity or nonreactivity are important. a. Abnormal baseline fetal heart rate or beat-to-beat variability b. Fetal heart rate decelerations 5. Amniotic fluid volume assessment is important particularly in cases of postdates and intrauterine growth retardation. 6. Condition-specific AFHRT (i.e., modifications of schemes to fit clinical circumstances) is an important concept. 7. Testing at gestational ages of 26 to 28 weeks may be appropriate in certain situations. After 28 weeks, AFHRT can be used reliably. 8. The integration of an AFHRT scheme into the total clinical picture is the key to success.