San Gabriel Valley Perinatal Medical Group
Antenatal Testing Guidelines

INDICATION

 INITIATION OF TESTING FREQUENCY OF TESTING
Chronic hypertension 
 		 32-34 weeks NST/AFI  2X/wk
Chronic hypertension with 
SLE, SGA, DM, Or PIH 
 		 26-28 weeks NST/AFI  2X/wk
Cholestasis of pregnancy 
 		 32-34 weeks NST/AFI  2X/wk
Decreased fetal movement 
 		 At diagnosis NST/AFI once
Diabetes A1 
 		 40 weeks NST/AFI  2X/wk

A2-RF

 32-34 weeks NST/AFI  2X/wk

any class with HTN, renal dz, SGA

 26-28 weeks NST/AFI  2X/wk
Elevated AFP/HCG 
 		 32-34 weeks NST/AFI  2X/wk
Fetal arrhythmia 
 		 At diagnosis NST/AFI  2X/wk
Fetal anomalies 
 		 As indicated  NST/AFI  2X/wk
Hemoglobinopathy 
 		 32-34 weeks NST/AFI  2X/wk
History of stillbirth 32-34 weeks  
1 week prior to previous demise 
 		 NST/AFI  2X/wk
HIV( > antiviral agents) 
 		 32-34 weeks NST/AFI  2X/wk
IUGR 
 		 At diagnosis NST/AFI  2X/wk
Maternal cyanotic heart disease 
 		 32-34 weeks NST/AFI  2X/wk
Multiple gestation

Concordant growth

 32-34 weeks NST/AFI  2X/wk

Discordant growth

 At diagnosis NST/AFI  2X/wk

High order

 28 weeks NST/AFI  2X/wk
Maternal renal disease 
 		 32-34 weks NST/AFI  2X/wk
Phospholipid syndrome 26-28 weeks NST/AFI  2X/wk

Uncomplicated

 30-32 weeks NST/AFI  2X/wk
Unexplained polyhydramnios At diagnosis 
32-34 weeks		 NST/AFI  2X/wk
Postdates 
 		 41 weeks NST/AFI  2X/wk
Preterm labor on tocolysis 
 		 At diagnosis prn
Rh sensitization 
 		 26-28 weeks NST/AFI  2X-7X/wk
SLE 
 		 26-28 weeks NST/AFI  2X/wk
Thyroid disorder with antibodies 32-34 weeks NST/AFI  2X/wk

References
1. Adams D, Druzin ML, Edersheim t et al. Condition specific antepartum testing: sytemic lupus erythematosus and associated serologic abnormaliites. Am J Reprod Immunol. 1992;28:159-163

2.American College of Obstetrics and Gynecology, ACOG Technical Educational Bulletin, Washington, DC: ACOG,1998

3.Druzin ML, Lockshin M, Edersheim TG, Hutsin JM, Krause AL,Kogut E.Second trimester fetal monitoring and preterm delivery in pregtnancies with systemic lupus eryhtematosus and/or circulating anticoagulant. Am J Obstet Gynecol 1987;157:1503-1510

4.Druzin ML, Karver ML,Wagner W, et al. Prospective evaluation of the contraction stress and nonstress tests in the management of posterm pregnancy. Gynecol Obstet Sur 1992; 174:507-512

5. Elliot JP, Finberg HJ, Biophysical profile testing as an indicator of fetal well-being in high-order multiple gestations. Am J Obstet Gynecol. 1995; 172:508-512.

6. Kjos SL, Leung A,  Henry OA et al. Antepartum surveillance in diabetic pregnancies, predictors of fetal distress in labor. Am J Obstet Gynecol 1995;173:1532-1539.

7. Lagrew DC,  Pircon RA, Towers CV, et al. Antepartum fetal surveillance in patients with diabetes: when to start? Am J Obstet Gynecol. 1993;1681:1820-1826

8. Landon MB, Gabbe SG. Fetal surveillance and timing of delivery in pregnancy complicated by diabetes mellitus. Obstet Gynecol Clini North Am 1996; 23(1):109-123

9.Miller DA, Rabello YA, Paul RH. The modified biophysical profile: antepartum testing in the 1990s. Am J Obstet Gynecol. 1996:17:812-817

10. Nageotte MP, Towers CV, Asrat T et al. The value of a negative antepartum test: CST and modified BPP. Obstet Gynecol 1994; 94:231-234

11. Nageotte MP, Towers CV, Asrat T et al. Perinatal outcome with the modified biophysical profile. Am J Obstet Gynecol 1994;170:1672-1676

12. Pircon RA, Lagrew DC, Towers CV et al. Antepartum testing in the hypertensive patient: when to begin. Am J Obstet Gynecol 1991;164:1563-1570

13. Weeks JW, Asrat T, Morgan MA et al Antepartum surveillance for a history of stillbirth: when to begin? Am J Obstet Gynecol. 1995; 486-492
 

Last Reviewed 3/18/2001