Antenatal monitoring

For those women who decline induction of labour for prolonged pregnancy there is no strong evidence supporting an effective moni­toring regimen to prevent adverse outcome. Various tests of fetal well-being have been investigated including ultrasound assessment of amniotic fluid, biophysical profile, cardiotocography, formal fetal movement counting, and umbilical artery Doppler velocimetry. NICE recommends that women who decline induction be offered twice-weekly cardiotocography and ultrasound estimation of max­imum amniotic pool depth from 42⁺⁰ weeks onwards (15).