|Source||Location and Type of Study||Intervention||Stillbirths/Perinatal Outcomes|
|Reviews and meta-analyses|
|Lalor et al. 2008 ||
Meta-analysis (Cochrane). 4 RCTs included (N = 2839 pregnant women).
|Compared the effects of complex (BPP; intervention) vs. simple fetal monitoring (cardiotocography and maximum pool depth) (controls).||
PMR (including major malformations): RR = 1.33 (95% CI: 0.60–2.98) [NS]|
[13/1405 vs. 10/1434 in intervention vs. control groups, respectively].
PMR: RR = 1.30 (95% CI: 0.58–2.92) [NS]
[13/1405 vs. 11/1434 in intervention vs. control groups, respectively].
|Awad 1991 ||
Egypt. Al Fayrouz Hospital.|
Before-after study. N = 319 women (N = 160 intervention, N = 159 controls). Routine BPP introduced in 1990; compared to historical controls without BPP at same hospital prior to 1990.
|Assessed the impact on perinatal mortality of introduction of routine BPP (intervention) vs. historical controls.||
SBR: 0/1000 vs. 6/29/1000 in intervention vs. control groups, respectively.|
PMR (excluding malformations and alloimmunization disorders): 6.25/1000 vs. 25.16/1000 in intervention vs. control groups, respectively.
|Golde et al. 1984 ||
USA. University of Southern California Medical Centre and Women's Hospital, Los Angeles,|
Case series. Pregnant diabetic women (N = 107) vs. historic controls (N = 140) undergoing antepartum fetal surveillance.
|Compared the impact of a package of nonstress heart rate testing, backed up by either fetal BPP or CST twice weekly (intervention), vs. weekly NSTs and daily plasma estriols (controls).||SB: 3/107 vs. 1/140 in intervention vs. control groups, respectively. 0 unexplained losses in either group.|
|de la Vega A 2002 ||
Puerto Rico. Private clinic.|
Case series. Pregnancies (N = 1810) ≥20 wks gestation. High-resolution sonograph was performed in each trimester; BPP in 3rd trimester if risk factor was identified.
|To assess the impact of testing fetal well-being using sonography and BPP in clinic cases (intervention) compared with the US average.||SBR: 14/1810 (7.7/1000 births) in this series vs. the U.S. national average of 6.7–7.8/1000 births.|
|Kennelly et al. 2007 ||
UK. Single tertiary centre.|
Retrospective study. Records from Fetal Medicine Database, 2000–2005. Pregnant women (N = 39) with SGA twins (19 monochorionic sets, 13 dichorionic sets) with absent or reversed end diastolic flow in the umbilical artery.
|To assess the impact of active monitoring with daily BPP after estimated fetal weight ≥500 g in both twins and gestational age ≥24 wks. Delivery was timed based on abnormal BPP, two equivocal BPP within 12 h or gestational age ≥32 wks.||Fetal death (miscarriage+SB): None.|