Antepartum fetal heart rate testing and the post-term gestation.

Abstract

With the advent of continuous fetal heart rate monitoring, the obstetrician has been better able to assess the Status of fetal well-being in normal as well as high risk pregnancies. Antepartum fetal heart rate testing (AFHRT) was first introduced by HAMMACHER [5,6]. Subsequently, the test has been refined and popularized in the United States by several groups [13, 14]. It is well-known that the post-term fetus is subject to increased perinatal morbidity and mortality from fetal dysmaturity, fetal distress, meconium aspiration, congenital anomalies and macrosomia [3, 8, 9, 18]. Recent literature on AFHRT has demonstrated that the largest single high risk indication for the performance of an AFHRT is that of the post-term gestation [10, 15]. Because the post-term gestation comprises the largest population in these previous studies, we have attempted to isolate and examine this group of patients at increased risk for placental insufficiency. The purpose of this study is to evaluate the experience at the Columbia-Presbyterian Medical Center with AFHRT in the management of the post-term gestation.