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Antepartum Testing for the Prevention of Stillbirth

Where Do We Go From Here?

Johnson, Grace J., MD; Clark, Steven L., MD; Turrentine, Mark A., MD

doi: 10.1097/AOG.0000000000002967
Obstetrics: Current Commentary: PDF Only

Unexpected antepartum fetal demise remains one of the most tragic complications of pregnancy. Various approaches to antepartum fetal assessment have been developed as a means of either reassuring the clinician of fetal well-being or identifying potential fetal jeopardy and the need for delivery. As additional high-risk groups of women are identified, indications for antenatal testing continue to expand despite a paucity of good-quality data linking such testing to improved outcomes for women with these additional risk factors. The expansion of established antepartum testing protocols to include women with conditions such as advanced maternal age or obesity without additional, well-established indications for testing is not warranted, particularly because baseline rates of stillbirth seen with these conditions before 39 weeks of gestation are already lower than stillbirth rates achieved with current antepartum testing protocols. Beyond 39 weeks of gestation, if the established risks of stillbirth are deemed unacceptable, delivery is a more rational and evidence-based approach than antepartum testing.

Beyond 39 weeks of gestation, delivery is a more rational and evidence-based approach than antepartum testing.

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.

Corresponding author: Mark A. Turrentine, MD, Baylor College of Medicine, 6651 Main Street, Suite F1020, Houston, TX 77030; email: mark.turrentine@bcm.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

Peer review history is available at http://links.lww.com/AOG/B188.

Received July 23, 2018

Received in revised form August 27, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.