In a pregnant patient with a prior stillbirth, what is the recommended monitoring approach for the next pregnancy?

• A. Routine Amniocentesis Every Week
• B. Nonstress Testing In The Third Trimester
• C. Immediate Induction At 38 Weeks
• D. No Special Monitoring Is Needed

Answer: (B)

In a pregnancy with a history of stillbirth, close fetal well-being surveillance is essential. Nonstress testing is a noninvasive way to monitor how well the fetus is doing by assessing the fetal heart rate in response to movement. A reactive NST, which shows at least two fetal heart rate accelerations within a 20-minute window, suggests good oxygenation and fetal reserve. This makes NST in the third trimester a practical, evidence-based approach to detecting potential fetal compromise early and guiding further management, including timing of delivery if concerns arise.

Routine invasive tests like amniocentesis are not used regularly for monitoring fetal well-being in this setting and carry risks without giving real-time information about fetal oxygenation. Inducing labor at a fixed time (such as 38 weeks) isn’t automatically indicated simply because of prior stillbirth; monitoring findings drive delivery decisions. If the NST is nonreactive, additional testing such as a biophysical profile or Doppler studies can be used to further assess fetal status. No special monitoring would be inappropriate given the increased risk associated with a prior stillbirth.