Table 3.

Summary of common indications for nonstress tests and how we have modified frequency of testing in setting of additional risks related to COVID-19 exposure and transmission

Indication for NST	Gestational age to begin 1 time/wk	Gestational age to begin 2 times/wk	Comments	COVID-19a
AMA	36			Fetal kick counts instead of NST
Cholestasis	Diagnosis
Decreased fetal movement	Diagnosis			One time only
Pregestational diabetes	32	36		Weekly only
GDMA2	32	36		Weekly only
Chronic HTN	32			36 weeks if no medications
Gestational HTN		Diagnosis		Weekly with home BP monitoring
Preeclampsia		Diagnosis		Weekly with home BP monitoring
CKD	32
IUGR		Diagnosis		Weekly with Doppler. Substitute BPP when possible
Elevated Dopplers		Diagnosis
SLE	32
Fetal arrhythmia	Diagnosis
Mono/Di twins	32
Di/Di twins			Only if additional indication
Obesity/BMI >40 kg/m2	32			Fetal kick counts instead of NST
Oligohydramnios	Diagnosis
Polyhydramnios	Diagnosis			Diagnosis or at 32 wks if <32 wk diagnosis. Only for AFI >30
Prior IUFD	32		1 wk prior to IUFD
Sickle cell disease	32			Kick counts if well controlled
Single umbilical artery	32			Fetal kick counts if normal growth, normal anatomy, normal genetic screening

AMA, advanced maternal age; BMI, body mass index; BP, blood pressure; BPP, biophysical profile; CKD, chronic kidney diseases; COVID-19, coronavirus 2019; Di/Di, dichorionic diamniotic; GDMA2, gestational diabetes-A2; HTN, hypertension; ; IUFD, intrauterine fetal demise IUGR, intrauterine growth restriction; Mono-Di, monochorionic diamniotic; NST, nonstress test; SLE, systemic lupus erythematosus.

Boelig. MFM guidance for COVID-19. Am J Obstet Gynecol MFM 2020.

^aText in column indicates changes to recommendations in setting of COVID, and no change in practice is suggested if this column is empty.