A study was undertaken to evaluate the use of nonstress testing in a physician's office in the management of high-risk pregnancies. A total of 1,485 office nonstress tests were done on 713 high-risk patients between 32 and 43 weeks' gestation. When indicated the contraction stress test was done in hospital. In all, 485 patients had a nonstress test within a week of their delivery, 97% of which were reactive and 2% were nonreactive. Those fetuses with a nonreactive test result had a significantly increased incidence of abnormal fetal heart rate patterns during labor and intrapartum fetal distress leading to cesarean delivery. With strict adherence to a protocol, nonstress testing in the physician's office can be successful in caring for fetuses thought to be at risk.