Assessing antepartum fetal health

Most pregnancies lead to the delivery of a healthy baby, irrespective of risk factors. Some pregnancies, however, are complicated by differing pathologies that can lead to increased risk of perinatal morbidity and mortality. Fetal surveillance should be instituted, attempting to identify at-risk fetuses and reduce their chances of complications. Traditionally obstetricians have classified pregnancies into ‘low-risk’ or ‘high-risk’ and applied surveillance tools to the latter group. However, the majority of stillbirths occur in low-risk women. In this article we will evaluate the evidence behind the current tools used to assess antepartum fetal health in both high- and low-risk groups, and their ability to detect an at-risk fetus or improve outcome. This article does not address fetal surveillance during labour.