Which biophysical tests are used for fetal monitoring in women with gestational diabetes mellitus (GDM)?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Various fetal biophysical tests are available to the clinician to ensure that the fetus is well oxygenated, including fetal heart rate testing, fetal movement assessment, ultrasonographic biophysical scoring, and fetal umbilical Doppler ultrasonographic studies (see the table below). If applied properly, most of these tests can be used with confidence to provide assurance of fetal well-being while awaiting fetal maturity.

Table 3. Biophysical Tests of Fetal Well-Being for Diabetic Pregnancy (Open Table in a new window)


<TEST<< P>Test




Reassuring Result



Fetal movement counting

Every night from 28 weeks

10 movements in < 60 min

Performed in all patients

Nonstress test (NST)

Twice weekly

2 heart rate accelerations in 20 min

Begin at 28-34 weeks with insulin-dependent diabetes, and begin at 36 weeks in diet-controlled GDM.

Contraction stress test


No heart rate decelerations in response to 3 contractions in 10 min

Same as for NST

Ultrasonographic biophysical profile


Score of 8 in 30 min

3 movements = 2

1 flexion = 2

30 s breathing = 2

2 cm amniotic fluid = 2

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