A fetal well-being assessment is done to check the growth and development of the baby. It is also done to assess any risks to the fetus in-utero. It consists of special tests done to screen high-risk factors that may affect the fetus. Furthermore, it also ensures satisfactory growth and well-being of the fetus. Some of these tests or checks like kick counting are required to be done by all mothers after a certain point in pregnancy, as advised by your Ob-gyn. However, other tests are done only in special conditions where the pregnancy is a high-risk one and the fetus needs additional monitoring.
When are these tests normally done?
These tests are normally done in the 3rd trimester, usually 30 weeks onwards. They are done on a biweekly basis. However, these can be done earlier or more frequently when the pregnancy is a high-risk one and requires close monitoring.
What are the tests done to assess fetal well-being?
A battery of clinical and biochemical tests are done at every visit to assess fetal growth. These clinical parameters include maternal weight gain, blood pressure, uterus size, and fundal height with documentation of abdominal girth.
The biochemical tests are done to assess fetal lung maturity via amniocentesis which is done by removing the amniotic fluid. Don’t worry, it is a very simple and safe test.
Apart from these tests, a few special tests are done in the later part of pregnancy to screen for any high risks.
What special tests are done?
These tests are recommended by your ob-gyn
1. Fetal movement assessment
One simple and cost-effective way to assess a baby’s well-being in the womb is to keep a track of the baby’s movements. This can be done in the comfort of your home and can be done by all mothers regularly after 26- 28 weeks or as advised by your Ob-gyn.
Your ob-gyn might also give you a baby-kick chart for you to notify every time you feel your baby kick. This helps you to note the pattern of your baby’s movements and report accordingly.
2. Non-stress test (NST)
This test is done to assess fetal distress by taking the Fetal heart Rate (FHR) in correspondence to the Fetal movements.
It is an OPD-based procedure. A belt is tied around your belly and the fetal heart rate is monitored.
Result of the test –
- Reactive/ Reassuring NST indicates that 2 or more accelerations are seen over 20 minutes. It indicates that the baby is healthy.
- If the result is Non-Reactive, it indicates that the baby is in distress. This could be due to a lack of oxygen or that the baby was asleep. In such cases, a repeat test needs to be done, or the baby is stimulated by passing sound through the abdomen.
3. Biophysical profile
It is a scoring system that uses 5 parameters to evaluate fetal wellbeing.
- Fetal breathing movements
- Fetal Heart Rate
- Fetal body movements
- Fetal muscle tone
- Amniotic fluid amount
Result of the test
- Each of the parameters is given a point of 0 or 2, and the total is calculated.
- A total score of 8- 10 is reassuring. A score of 6 is considered neutral (neither reassuring nor non-reassuring) and a repeat test is recommended.
4. Modified biophysical profile
It is the same as the BPP in many aspects. It includes NST and an amniotic fluid assessment done via ultrasound. Furthermore, it is hassle-free and provides the same test result with respect to fetal wellbeing as the BPP.
Result of the test
- Amniotic fluid assessment is done via ultrasound and NST is done as mentioned earlier. As stated above, if the test result is non-reassuring, it means that the fetus is not getting enough oxygen.
5. Doppler umbilical artery
It is another fetal well-being assessment test that records the flow of blood in the umbilical artery. When used in conjunction with other tests, it gives an idea of fetal growth and development.
This test is done along the same lines as the other tests. The mother lays down, and sound waves are passed over the abdomen. The computer picks up the image and shows it on the screen. The results are assessed accordingly.
Result of the test
- A normal blood flow in the blood vessel of the umbilicus indicates a normal fetus. Any abnormal flow in the umbilical artery indicates oxygen compromise to the fetus.
References
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https://www.acog.org/womens-health/faqs/special-tests-for-monitoring-fetal-well-being