Antenatal fetal monitoring is the principal means of distinguishing the fetus requiring imminent delivery from that which is coping well in utero. The ability to detect fetal compromise, defined by fetal acidosis, in a low-risk population was evaluated in a prospective study of 50 women undergoing a Caesarean section in the absence of labour. The sensitivity and positive predictive value of a modified biophysical profile (BPP) or Doppler velocimetry to detect a fetus subsequently born with an umbilical artery pH of less than 7.20 was poor. The incidence of fetal acidosis in the population under study was 8%. Interpretation of antenatal fetal assessments must be tempered by the clinical features of each case. Decisions to deliver should take into account the low sensitivity of these tests in the absence of other complicating factors.
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