Evaluation of non-stress test as predictor of perinatal outcome in high risk and low risk pregnancy: a prospective study

Background: NST is simple, cheap, non-harmful, easily repeated, and cost effective with low maintenance profile. NST is a very effective method to investigating the intrauterine growth retardation (IUGR), late pregnancy, premature birth, multiple pregnancy, Rh sensitivity, diabetes, liver disease, decreased bowel movements, oligohydramnios etc. Objectives were to evaluate the efficacy and role of antenatal NST in improving perinatal outcome in high-risk pregnancies.Methods: This prospective study was done among 100 pregnant women (group A: high risk pregnancy, n=50, group B: low risk pregnancy, n=50). Nonstress test was done for 20 minutes if the test was inconclusive or nonreactive. It was continued for another 20 minutes extended CTG. Fetal stimulation was also done. The NST done before onset of labour was used as reference. Interpretation if NST tracings was done according to ACOG guideline.Results: Around 58% participants of high-risk group and 82% of low-risk group had ‘reactive’ and NST tracings respectively. Almost 36% participants of high-risk group and 16% of low-risk group were delivered baby by LSCS method. Around 24% participants of high-risk group and 10% of low-risk group had meconium-stained amniotic fluid. Around 66% babies of participants of high-risk group and 24% of low-risk group were admitted in NICU. The mean birth weight of babies of high-risk group participants was 2.52 kg and of low-risk group participants was 2.85 kg.Conclusions: Present study reveals significant difference between reactive and nonreactive NST in terms of Apgar scores and NICU admissions in both the groups. Hence judicious use of NST will certainly help in timely identification of at-risk fetuses thereby avoiding unnecessary delay in intervention.

Evaluation of non-stress test as predictor of perinatal outcome in high risk and low risk pregnancy: a prospective study

Background: NST is simple, cheap, non-harmful, easily repeated, and cost effective with low maintenance profile. NST is a very effective method to investigating the intrauterine growth retardation (IUGR), late pregnancy, premature birth, multiple pregnancy, Rh sensitivity, diabetes, liver disease, decreased bowel movements, oligohydramnios etc. Objectives were to evaluate the efficacy and role of antenatal NST in improving perinatal outcome in high-risk pregnancies.Methods: This prospective study was done among 100 pregnant women (group A: high risk pregnancy, n=50, group B: low risk pregnancy, n=50). Nonstress test was done for 20 minutes if the test was inconclusive or nonreactive. It was continued for another 20 minutes extended CTG. Fetal stimulation was also done. The NST done before onset of labour was used as reference. Interpretation if NST tracings was done according to ACOG guideline.Results: Around 58% participants of high-risk group and 82% of low-risk group had ‘reactive’ and NST tracings respectively. Almost 36% participants of high-risk group and 16% of low-risk group were delivered baby by LSCS method. Around 24% participants of high-risk group and 10% of low-risk group had meconium-stained amniotic fluid. Around 66% babies of participants of high-risk group and 24% of low-risk group were admitted in NICU. The mean birth weight of babies of high-risk group participants was 2.52 kg and of low-risk group participants was 2.85 kg.Conclusions: Present study reveals significant difference between reactive and nonreactive NST in terms of Apgar scores and NICU admissions in both the groups. Hence judicious use of NST will certainly help in timely identification of at-risk fetuses thereby avoiding unnecessary delay in intervention.

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

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.