Fetal Growth and Well-being Assessment

Assessment of fetal growth and well-being is an essential part of antenatal care to ensure that the fetus is developing normally and is not under any distress. Various clinical and instrumental methods are used to evaluate fetal health throughout pregnancy.

1. Fetal Monitoring
Fetal monitoring helps in assessing the fetal heart rate (FHR) and detecting early signs of distress.
• Auscultation: Using a stethoscope or handheld Doppler to check FHR.
• Non-Stress Test (NST): Records FHR and its accelerations in response to fetal movements — a reactive NST indicates good fetal health.
• Contraction Stress Test (CST): Evaluates fetal response to uterine contractions, used when NST is non-reactive.

2. Biophysical Profile (BPP)
The Biophysical Profile is a comprehensive ultrasound-based assessment combining fetal movement, tone, breathing, amniotic fluid volume, and NST results.
Each of the five parameters is scored 0 or 2, giving a total score out of 10.
• 8–10: Normal (reassuring)
• 6: Equivocal – requires repeat test or further evaluation
• ≤\4: Abnormal – suggests fetal compromise

3. Doppler Studies
Doppler ultrasound evaluates blood flow in fetal and placental circulation to detect any compromise in oxygen or nutrient supply.
• Umbilical artery Doppler: Assesses placental resistance.
• Middle cerebral artery (MCA) Doppler: Reflects fetal oxygenation and anemia status.
• Uterine artery Doppler: Indicates maternal placental perfusion and risk of preeclampsia or growth restriction.
Abnormal Doppler findings may indicate fetal growth restriction (FGR) or placental insufficiency, guiding timely intervention or delivery.

Conclusion
Regular assessment of fetal growth and well-being using fetal monitoring, biophysical profile, and Doppler studies ensures early detection of problems and helps optimize pregnancy outcomes.