Antepartum Fetal Surveillance: ACOG Practice Bulletin, Number 229

Obstet Gynecol. 2021 Jun 1;137(6):e116-e127. doi: 10.1097/AOG.0000000000004410.


The goal of antepartum fetal surveillance is to reduce the risk of stillbirth. Antepartum fetal surveillance techniques based on assessment of fetal heart rate (FHR) patterns have been in clinical use for almost four decades and are used along with real-time ultrasonography and umbilical artery Doppler velocimetry to evaluate fetal well-being. Antepartum fetal surveillance techniques are routinely used to assess the risk of fetal death in pregnancies complicated by preexisting maternal conditions (eg, diabetes mellitus) as well as those in which complications have developed (eg, fetal growth restriction). The purpose of this document is to provide a review of the current indications for and techniques of antepartum fetal surveillance and outline management guidelines for antepartum fetal surveillance that are consistent with the best scientific evidence.

Publication types

  • Practice Guideline

MeSH terms

  • Blood Flow Velocity
  • Female
  • Fetal Death / prevention & control
  • Fetal Distress / diagnosis*
  • Fetal Distress / physiopathology*
  • Fetal Movement
  • Heart Rate, Fetal
  • Humans
  • Oligohydramnios / diagnostic imaging
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / physiopathology*
  • Prenatal Diagnosis / methods*
  • Stillbirth
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal
  • Umbilical Arteries / diagnostic imaging*
  • Umbilical Arteries / physiopathology
  • Uterine Contraction