In a patient with postdates gestation, when should fetal surveillance be initiated?

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Abstract

EVIDENCE-BASED ANSWER

Oligohydramnios in uncomplicated pregnancies after 39 plus 6 weeks’ gestation predicts an increased risk of adverse outcomes (positive likelihood ratio 1.9) (SOR: B, cross-sectional study). Use of a screening non-stress test (NST) between 40 and 40 plus 6 weeks’ gestation is not associated with improved outcomes (SOR: B, retrospective cohort study). Abnormal fetal testing and adverse maternal and perinatal outcomes are increased after 41 weeks’ gestation (SOR: B, retrospective cohort study). Initiating antenatal surveillance at or beyond 41 weeks of gestation may be indicated (SOR: C, expert opinion).

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