The nonstress test (NST) remains in widespread use forantepartum fetal surveillance. Our institutional experiencewith 14,028 patients and 38,645 tests over eight years revealsa fetal death rate of 2.6 per 1000 within seven days of areactive NST. The autopsy findings of 53 fetal deaths arepresented. The most common findings, in descending orderof frequency, were meconium aspiration, perinatal infec-tion, and abnormal umbilical cord position. These findingssupport changes we have made in our anteparturn assess-ment protocols.