Examination component	Recommendation	Label	Comments
Abdominal palpation	Abdominal palpation should be used to assess fetal presentation beginning at 36 weeks’ gestation.34,35	B	Abdominal palpation should not be done before 36 weeks’ gestation because of potential inaccuracies and discomfort to the patient.
Blood pressure measurement	It is not known how often blood pressure should be measured, but most guidelines recommend measurement at each antenatal visit.27	C	Further research is required to determine how often blood pressure should be measured.
Evaluation for edema	Edema occurs in 80 percent of pregnant women. It lacks specificity and sensitivity for the diagnosis of preeclampsia.36	C	Edema is defined as greater than 1+ pitting edema after 12 hours of bed rest, or weight gain of 2.3 kg (5 lb) in one week.
Fetal heart tones	Auscultation for fetal heart tones is recommended at each antenatal visit. Heart tones confirm a viable fetus, but there is no evidence of other clinical or predictive value.10,33	C	It is thought that fetal heart tone auscultation provides psychologic reassurance to the mother, but this potential benefit has not been studied.
Fetal movement counts	Routine fetal movement counting should not be performed.37,38	A	——
Symphysis fundus height measurement	Symphysis fundus height should be measured at each antenatal visit. Plotting the measurement on a graph is suggested for monitoring purposes.39–42	B	Measurement of the symphysis fundus height is subject to interobserver and intraobserver error. It is a simple, inexpensive test.
Urinalysis	Dipstick urinalysis does not detect proteinuria reliably in patients with early preeclampsia; measurement of 24-hour urinary protein excretion is the gold standard but is not always practical. Trace glycosuria also is unreliable, although higher concentrations may be useful.43–45	C	Some guidelines have encouraged discontinuation of dipstick urinalysis; others retain this test as part of the routine antenatal visit.
Weight measurement	Maternal height and weight measurementsshould be made at the first antenatal visit to determine body mass index, which is the basis for recommended weight gain in pregnancy.46–49	B	Patients who are underweight or overweight have known risks. Weight gain is not associated with pregnancy induced hypertension.
	Maternal weight should be measured at each antenatal visit.46–49	C