Antepartum fetal surveillance Quiz: Ace Your Exams

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A 29-year-old woman, gravida 2, para 1, presents for antepartum fetal surveillance at 35 weeks of estimated gestational age (EGA). The pregnancy has been complicated by a chronic placental abruption and gestational hypertension, both diagnosed after an episode of light vaginal bleeding at 30 weeks EGA. Ultrasound at 20 weeks EGA was normal. The patient has had several additional episodes of light spotting since. Today, she is asymptomatic. Her first delivery was an uncomplicated vaginal delivery at 40 weeks EGA, and her only medication is a prenatal vitamin. An ultrasound is performed, showing an estimated fetal weight at the fourth percentile for EGA. Umbilical artery Doppler velocimetry shows forward blood flow through the umbilical arteries during fetal systole, with no flow during diastole. The single deepest pocket of amniotic fluid is 4.5 cm. What do the antepartum surveillance findings indicate for this patient?

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Equivocal findings, schedule a biophysical profile within 24 hours

Mild fetal anemia, schedule additional testing at the recommended interval

Normal findings, schedule additional testing at the recommended interval

Severely increased placental resistance, consider delivery

Fetal cardiac dysfunction, consider inpatient observation