Prenatal surveillance using nonstress testing and Doppler velocimetry.

One hundred forty pregnant women referred to our prenatal testing laboratory for conventional nonstress testing (NST) also had a Doppler study of the umbilical arteries. The outcomes of 88 women with abnormal testing (NST or Doppler) were compared with the outcomes of 52 women who had normal results on both tests. The results demonstrated that 50% of the fetuses with decreased flow velocity who later developed an abnormal NST were growth-retarded, 75% required a cesarean section, and 63% were admitted to the neonatal intensive care unit. Development of an abnormal NST in the presence of normal velocimetry studies occurred most frequently in the postdates pregnancy; 32% required cesarean section for fetal distress. Knowledge of the umbilical circulation through Doppler studies may be of benefit when selecting patients for NST and when interpreting results.