The role of non-stress test as a method to evaluate the outcome of high-risk pregnancy: a tertiary care center experience

Authors

  • Shreya Singh Department of Obstetrics and Gynecology, MCH Wing, Chandauli, UP, India
  • H. K. Premi Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, UP, India
  • Ranjana Gupta Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, UP, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202033

Keywords:

Non stress test, Acceleration, Bio physical profile, Fetal heart rate, Fetal movement, Contraction stress test

Abstract

Background: Non-stress test (NST) is a graphical recording of changes in fetal heart activity and uterine contraction along with fetal movement when uterus is quiescent. NST is primarily a test of fetal condition and it differs from contraction stress test which is a test of uteroplacental function. The present study aimed at evaluating the efficacy and diagnostic value of NST for antenatal surveillance in high-risk pregnancy and comparing the mode of delivery with test results.

Methods: A clinical study of NST was done between November 2014 to October 2015. NST was used for their surveillance from 32 weeks of gestation and NST was recorded weekly, biweekly, on alternate days or even on daily basis depending on high risk factors and were followed up.

Results: A total of 100 cases were enrolled in the study. The mean age of patients was 25.09±3.78 years. In all 14 cases (23.3%) with reactive NST underwent lower caesarean section (LSCS) whereas 36 cases (90%) with non-reactive NST underwent LSCS. The mean NST delivery interval with reactive NST was 9.8±7.1 hours and in cases with non-reactive NST it was 9.2±8.6 hours, the difference was statistically not significant (p=0.70).

Conclusions: NST tells about acute fetal hypoxia and decision to delivery time can be made for those patients with fetal distress so that a major improvement in the outcome among parturient can be achieved with abnormal NST results. An abnormal NST should alert the clinician of fetal compromise and has to be followed up by other biophysical tests.

Author Biographies

Shreya Singh, Department of Obstetrics and Gynecology, MCH Wing, Chandauli, UP, India

Consultant Gynaecologist , Department of OBGY, MCH Wing, Chandauli, UP, India

H. K. Premi, Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, UP, India

Professor & Head , Department of OBGY

Ranjana Gupta, Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, UP, India

Professor, Department of OBGY

References

Pongsakdi S, Manassagorn J, Vantanasiri C, Titadirok V, Sawasdimongkol S. Porntip Tontisirin Siriraj Hosp Gaz: antepartum non-stress test in high risk pregnancy. 1985;37:11:909-14.

Rochard F, Schifrin BS, Goupil F, Grad L, Blottiere J, Sureau J. Nonstress test fetal heart rate monitoring in the antepartum period. Am J Obstet Gynecol. 1976;126:(6):699-706.

Schifrin BS, Foye G, Amato J, Kates R, Mackenna J. Routine fetal heart rate monitoring in the antepartum period. Obstet Gynecol. 1979;54(1)21-5.

Phillips PWD, Towell ME. Abnormal fetal heart rate associated with congenital abnormalities. Br J Obstet Gynaecol. 1980;87:(4):270-4.

Lin CC, Devoe LD, River P, Moawad AH. Oxytocin challenge test and intrauterine growth retardation. Am J Obstet Gynecol. 1981;140:282.

Sorokin Y, Pillay SK, Dierker LJ, Zador IE, Schreiner ML, Rosen MG. The association between fetal heart rate patterns and fetal movements in pregnancies between 20- and 30-weeks’ gestation. Am J Obstet Gynecol. 1982;143:243.

Devoe LD, Azor H. Simultaneous non stress fetal heart rate testing in twin pregnancy. Obstet Gynecol. 1981;58(4):450.

Nayot D, Yosef MS, Granat M. Antepartum fetal heart rate pattern associated with major congenital malformations. Obstet Gynecol. 1984;63:414.

American College of Obstetrics and Gynaecologists: Antepartum Fetal Surveillance Practice B ulletin 9. Washington DC; 1999.

Flynn AM, Kelly J, Mathews K. Predictive value of and observer variability in several ways of reporting antepartum cardiotocographs: Br J Obstet Gynecol. 1982;89:434-40.

Kelly VC, Kulkarni D. Five years study of continuos monitoring on obstetrical service. Obstet Gynaecol. 1973;41:6-9.

Bhide AA, Bhattacharya MS. Predictive value of the non- reactive nonstress test in evaluating neonatal outcome. J Postgraduate Med. 1990;36:104-5.

Ocak VF, Demirkiran C, Sen U, Colgar F, Ocer O, Kilavuz, Uras Y. Predictive value of fetal heart rate monitoring. European J Obstetrics Gynaecology Reproductive Biology. 1992;44:53-8.

Petrikovsky BM, Kaplan GP. Diurnal non-stress test variations in healthy term fetuses. Early human development. 1996;44:127-30.

Ott WJ. comparison of non-stress test with the evaluation of centralization of blood flow for the prediction of neonatal compromise. 1999;14:38-41.

Arulkumran S. In: Ratnam SS, Bhasker Rao K, Arulkumran S. Obstetrics and Gynaecology for post graduates (1st edition) Chennai: Orient Longman; 1992: 115-116.

Mahfuz Ara Begum, Shahla Khatun: The ORION. 2012: 12.

Denny JM, Waters TP, Gorman R, Pollock M, Sciscione AC. Choice of antenatal testing significantly effects a patient work obligation. J Perinatology. 2008;28:102-6.

Hoh JK, Park M, Park YS, Koh SK. The significance of amplitude and duration of fetal heart rate acceleration in non-stress test analysis. Taiwanese J Obstetrics Gynaecology; 2012.

Verma A, Shrimali L. Impact of admission non stress test as a screening procedure on perinatal outcome. Int J Med Pharmaceutical Sci. 2012;3(5):6-10.

Bano I, Noor N, Motwani L, Arshad Z. Comparative study of non-stress test and fetal acoustic stimulation of assessment of fetal well-being. 2012;3(2):169-71.

Lohana RU, Khatri M, Hariharan C. Correlation of non-stress test with fetal outcome in term pregnancy. Int J Reproduction Contraception Obstetrics Gynaecology. 2013;2(4):639-45.

Riahin AA, Lorzade N, Suri A, Gharehbeglou M, Rasuli A, Torkamani A, et al. The diagnostic value of non-stress test in patients with decreased amniotic fluid index and decreased fetal movements. 2013;2(1):22-6.

Kanan YA, Akshata P, Ganesh TG. Role of fetal Doppler and non-stress test in preeclampsia and intrauterine growth restriction. Journal Obstetrics Gynaecology India. 2013;63(3):168-72.

Biswas A, Biswas S, Walliullah MD, Mukhopadhyay AK. Indian Med Gazette. 2013.

Mehta L, Vyas M, Chauhan N, Shah A, Varia K. Role of non-stress test and Doppler in Assessment of Perinatal Outcome in High risk pregnancy. 2013;2(8):379-80.

Panchal VP. Color Doppler and non-stress test - useful diagnostic tool for fetal surveillance in high risk pregnancy. Int J Scientific Res. 2014;3(2):347-8.

Edessy MSE, Nasar AAM, Mustafa FA, Rashedy MIE, Sattar MAE, Saleh M. High risk pregnancy outcome in upper Egypt: Umbilical Artery Doppler versus Non-stress test. American J Res Communication. 2014;2(1):75-85.

Sekhavat L, Tabatabaei A. The effect of Different Maternal Position on Non-stress test (NST). World Applied Sci J. 2014;32(5):853-6.

Himabindu P, Sundari MT, Pavani S. Evaluation of Non-stress test in Monitoring High Risk Pregnancies. J Dental Med Sci. 2015:14(4):40-2.

Deshpande S, Deshpande AB, Khairnar NB. Evaluation of relation between result of non-stress test and mode of delivery in rural population. Int J Healthcare Biomed Res. 2015;3(4):135-9.

Raouf S, Sheikhen F, Hassanpour S, Bani S, Torabi R, Shamsalizadeh N. Diagnostic Value of Non stress test in Latent Phase of Labor and Maternal and Fetal outcomes. Global J Health Sci. 2015;7(2):177-82.

Shrestha P, Misha M, Shrestha S. A prospective study on impact of non-stress test in prediction of pregnancy outcome. American J Public Health Sci. 2015;3(4):45-8.

Patel S, Gupta S, Modi K, Desai A, Shah S, Pamnani D. Correlation of admission NST in low risk pregnancy with neonatal outcome. American J Ethnomedicine. 2015;2(2):79-83.

Jitesh SM, Meghana MN, Satyanarayan K. Antepartum fetal surveillance by non-stress test and its correlation with perinatal outcome. Perspective Med Res. 2015;3(2):3-5.

Subramanian V, Venkat J, Dhanapal M. Which is superior Doppler velocimetry or Non-stress test or both in predicting the perinatal outcome of high-risk pregnancies. J Obstetrics Gynaecol India. 2016;66:149-56.

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Published

2020-05-26

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Original Research Articles