Antenatal Testing Guidelines

San Gabriel Valley Perinatal Medical Group
Specialists in High Risk Pregnancy

Antenatal Testing Guidelines
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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
Antiphospholipid 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 Created: 3/18/2001 Anna Leung M.D. Updated: 3/18/2003 Anna Leung M.D.

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