This chapter is dedicated to analyzing methods for classifying pregnant females into low risk and high risk group and to methods used for the fetal surveillance. Preconception counseling, preimplantation diagnostic methods and role of molecular biology in antenatal fetal monitoring are also discussed. Cases with complications requiring specialized care for management include severe pre-eclampsia or eclampsia with renal failure, pulmonary edema, hypertension unresponsive to treatment, intracranial bleeding or severe HELLP syndrome. Amniotic fluid reflects the physiology of the fetus and the two important sources of AF are fetal urine, lung, and fetal oronasal cavities (to some extent). Biophysical tests have greatly increased the understanding of fetal behavior and development and have almost completely replaced biochemical tests. These tests include non-stress test (NST), contraction stress test (CST), fetal biophysical profile (BPP), vibroacoustic stimulation test (VAST), modified biophysical profile (MBPP), and umbilical and uterine Doppler ultrasound. Since many fetal deaths occur prior to the onset of labor, the stimulation of contractions with oxytocin and observing fetal heart rate under labor like conditions in pregnancies at risk is known as “oxytocin challenge test” or “contraction stress test”. If the amniotic fluid volume is decreased but the NST is reactive, a search for chronic fetal conditions, particularly congenital abnormalities is undertaken, and the frequency of MBPP testing is twice weekly. Pulsed Doppler sonography is useful for detection and evaluation of intrauterine growth restriction and other high-risk pregnancy complications. The role of umbilical artery waveforms is not established in fetuses of insulin dependent diabetics. Reversed frequencies in end-diastolic are only observed in a few fetuses prior to death. Detection of elevated resistance to flow within fetal descending aorta reflects the increased vascular resistance associated with high-risk pregnancy not only within the placental vascular bed but also within fetal abdominal viscera.