By definition it would be when you would be willing to act on an abnormal test, ie deliver. Since prognosis with iugr with or with out delivery poor<28, clinically might be better to risk iufd as opposed to neonatal death. Probably more issue closer to 24 weeks than 28 weeks. Insurance should pay for Antepartum testing and dopplers for FGR 24 weeks and above, providing u are willing to act on them. I've had some people say any breathing movement counts < 28 weeks, but I don't have a reference that I'm aware of so with FGR at 26 weeks I might just do dopplers and if normal and normal fluid just repeat and start testing at 28 weeks when more likely to get reassuring testing and be willing to act on if abnormal. 6/10 I would have to repeat in 12-24 hours in my mind or admit.
Sean P. Kenney, MD, FACOG
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