• Rosalie M Grivell, Lufee Wong, and Vineesh Bhatia.
• Discipline of Obstetrics and Gynaecology, University of Adelaide, Women's and Children's Hospital, 72 King William Road, Adelaide, Australia, SA 5006. rosalie.grivell@adelaide.edu.au
• Cochrane Db Syst Rev. 2009 Jan 21 (1): CD007113CD007113.

BackgroundPolicies and protocols for fetal surveillance in the pregnancy where impaired fetal growth is suspected vary widely, with numerous combinations of different surveillance methods.ObjectivesTo assess the effects of antenatal fetal surveillance regimens on important perinatal and maternal outcomes.Search StrategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2008).Selection CriteriaRandomised and quasi-randomised trials comparing the effects of described antenatal fetal surveillance regimens.Data Collection And AnalysisR Grivell and L Wong independently assessed trial eligibility and quality and extracted data.Main ResultsOne trial of 167 women and their babies was included. This trial was a pilot study recruiting alongside another study, therefore a separate sample size was not calculated. The trial compared a twice-weekly surveillance regimen (biophysical profile, nonstress tests, umbilical artery and middle cerebral artery Doppler and uterine artery Doppler) with the same regimen applied fortnightly (both groups had growth assessed fortnightly). There were insufficient data to assess this review's primary infant outcome of composite perinatal mortality and serious morbidity (although there were no perinatal deaths) and no difference was seen in the primary maternal outcome of emergency caesarean section for fetal distress. In keeping with the more frequent monitoring, mean gestational age at birth was four days less for the twice-weekly surveillance group compared with the fortnightly surveillance group. Women in the twice-weekly surveillance group were 25% more likely to have induction of labour than those in the fortnightly surveillance group. The risk ratio was 1.25 (95% confidence interval 1.04 to 1.50).Authors' ConclusionsThere is limited evidence from randomised controlled trials to inform best practice for fetal surveillance. regimens when caring for women with pregnancies affected by impaired fetal growth. More studies are needed to evaluate the effects of currently used fetal surveillance regimens in impaired fetal growth.

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