How can doctors check up on a fetus's well being?

Elena H. Yanushpolsky, MD
OBGYN (Obstetrics & Gynecology)

There are a number of ways doctors can and do check fetus’ well being, and the modalities vary depending on the time in pregnancy. In the first trimester doctors use a First Look protocol that involves an ultrasound between 11 and 13 weeks of pregnancy checking on the thickness the skin fold in the back of fetal neck (nuchal translucency). Abnormally thick neck skin fold may suggest presence of chromosomal abnormality. The entire First Look panel also includes blood tests (PAPP-A and total hCG) and gives an indication for the chances of fetal chromosomal abnormalities (Down’s Syndrome, trisomy 13, 18, and others).

In the second trimester doctors measure growth/enlargement of the uterus and assess fetal activity by asking the mother about fetal “kicks” once she begins to feel fetal movements. Appropriate growth of the uterus and fetal activity are excellent indications of fetal well-being.  Some doctors may recommend a “fetal survey” by ultrasound at around 18 weeks of pregnancy to evaluate major structures such as heart, kidneys, abdomen, and brain.  Appropriate fetal growth and activity as reported by the mother are excellent indicators of fetal well being in the third trimester. In addition, doctors may perform a non-stress test (NST), and biophysical profile (BPP) to confirm fetal well being.  NST is a recording of fetal heart activity looking for reassuring accelerations and beat-to-beat variability. BPP is an ultrasound assessment looking for appropriate fetal activity, breathing movements, muscle tone, heart rate accelerations, and adequate amount of amniotic fluid.

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