ANTENATAL CARE AND INTRAPARTUM MANAGEMENT

Cost-effective care is an increasingly important issue in medicine. Th is will necessitate re-evaluating many aspects of antenatal and intrap artum care, including health-care delivery systems and routine surveil lance techniques for uncommon events such as Down syndrome. It will de mand justification for broadening indications for cesarean section by including fetal macrosomia and intensify the search for the causes of preterm labor. As new techniques are developed for intrapartum monitor ing, such as fetal electrocardiography, fetal lactic acid levels, and near-infrared spectroscopy, they, too, will have to be determined to b e cost-effective before attaining a role in clinical management.