Our Services

Antepartum Testing

What is Antepartum Testing and why is it necessary? 
Many women experience certain conditions during their pregnancy that have the potential to effect how well the placenta functions. The Ante (before) partum (birth) Testing Center provides reassurance that the placenta is functioning well, and that the fetus is receiving adequate oxygen. Some common reasons mothers may need this surveillance are diabetes in pregnancy, high blood pressure, past due date, or multiple gestation.

How is Antepartum Testing performed?
Antepartum testing consists of two tests; the Amniotic Fluid Index (AFI) and a Non-Stress Test (NST).  Both tests are non-invasive. A registered nurse, with experience working in Labor and Delivery performs these tests.  The AFI involves a short ultrasound.  The purpose of this ultrasound is to observe the baby and to measure the amniotic fluid.  The baby’s position and movements will also be evaluated.  The deepest pocket of amniotic fluid in each quadrant of the uterus is measured in centimeters using the ultrasound machine.  These measurements are added, and the result is called the Amniotic Fluid Index, or AFI.  Second, the NST is performed.  The nurse uses a monitor to listen to fetal heart tones and assess for uterine contractions.  Two monitor pieces are held in place on the maternal abdomen by elastic belts.  One detects and graphs the fetal heart rate (FHR), the other detects uterine contractions.  If the FHR accelerates spontaneously twice in a 20 minute window, the NST is said to be reactive.  A reactive NST and an adequate AFI indicate a well functioning placenta, and that the fetus has an adequate store of. oxygen.

What if the NST is not reactive?
If the fetal heart rate does not accelerate the NST is non-reactive.  This does not indicate that anything is wrong, only that another tool to assess fetal well-being must be utilized.  The other tool used is the Biophysical Profile, or BPP.    The BPP looks at 5 different parameters and a score of either 0 or 2 is assigned for each, based on whether certain criteria for each parameter are met.  The five elements of a BPP are; the NST, the AFI, and observing 3 different types of fetal movement.  A score of 8 out of 10 possible points indicates a well functioning placenta.  Occasionally more observation is necessary than can be offered at San Francisco Perinatal Associates.  A perinatologist at SFPA will review the data collected by the nursing staff, and the patient’s doctor will be notified.  A decision may be made by your doctor to obtain more monitoring in the hospital setting.

Who can accompany me to my visit?
The addition of a new baby is an occasion many women want to share with family and friends. The Antepartum Testing Center at San Francisco Perinatal Associates welcomes partners, siblings, grandparents, and friends. Our nurses are experienced in labor and delivery and welcome all questions. However, if you prefer to come to your visit alone, it is a wonderful opportunity to connect with your baby during the ultrasound. DVD players are available for patients as well. Viewing choices range from educational material to toddler pleasing titles.

Our main goal is to provide reassurance in a welcoming, comfortable environment. For more information or to schedule an appointment, please call (415) 202-1200.