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Fetal wellbeing: monitoring and assessment

from Medical topics

Published online by Cambridge University Press:  18 December 2014

By
Peter G. Hepper ,
James C. Dornan  and
Dan McKenna
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Peter G. Hepper
Affiliation:
Queen's University
James C. Dornan
Affiliation:
Royal Jubilee Maternity Service
Dan McKenna
Affiliation:
Royal Jubilee Maternity Service
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

The main aim of obstetric practice is to ensure that mothers and babies remain healthy during pregnancy and birth. A variety of techniques may be employed to monitor and assess fetal health. This chapter concentrates upon techniques available to assess the health of the fetus. However it should be noted that the mother's health and wellbeing is inextricably linked to that of the fetus and a key element of antenatal care is the careful monitoring and management of the mother's health (see ‘Antenatal care’).

Key issues in assessing fetal wellbeing

The high-risk fetus in the low-risk population

Some mothers are classed as high-risk, i.e. at increased risk of having a baby with a problem due to some known factor, e.g. maternal age and Down's syndrome. Such mothers are relatively easy to identify and offered tests to assess the condition of their fetus (see ‘Screening: antenatal’). However the majority of fetal problems arise in the low-risk population of mothers, who present no obvious signs of having a fetus with an abnormality. A reduction in the incidence of fetal problems rests with advances in identifying the high-risk fetus in the low-risk population (McKenna et al., 2003).

Screening and diagnosis

Diagnostic techniques, whilst providing a definitive answer regarding the presence of a particular problem, can be expensive in time and money and carry a serious risk to the fetus, e.g. amniocentesis, which may result in a miscarriage. These tests are thus unsuitable for widespread use with the low-risk population.

Type
Chapter
Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 711 - 714
Publisher: Cambridge University Press
Print publication year: 2007

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References

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