ABSTRACT
Contraction stress tests (CSTs) interpreted as equivocal, with hyperstimulated contractions accompanied by late decelerations (hyperstimulation CSTs), were analyzed by test pattern and outcome and compared to a control group with negative CSTs. Outcome was evaluated for subsequent abnormal CST, low Apgar score, the presence of meconium, and cesarean section for fetal distress. Patients with hyperstimulation CSTs and solitary late decelerations, and the remainder of the test interpretable as a negative CST, had the least morbidity. In both the presence and absence of 10-minute negative windows, patients with more than one late deceleration were at significantly higher risk for cesarean section for fetal distress than controls. It would seem warranted in the presence of hyperstimulation CSTs, therefore, to repeat the CST within 24 hours regardless of the presence of a negative window.
Subject(s)
Fetal Monitoring/methods , Heart Rate, Fetal , Uterine Contraction , Cesarean Section/statistics & numerical data , Evaluation Studies as Topic , Female , Fetal Distress/epidemiology , Humans , Infant, Newborn , Nipples , Physical Stimulation , Pregnancy , Pregnancy Outcome/epidemiology , Retrospective Studies , Risk Factors , Stress, PhysiologicalABSTRACT
Nipple stimulation techniques for achieving a contraction stress test were evaluated prospectively in 1271 nipple stimulation contraction stress tests in 753 patients. Success was unrelated to parity, gestational age, or warm, moist towels but was related to the presence of spontaneous prestimulation contractions. Various stimulation techniques were equally successful in achieving a completed test in the presence of prestimulation contractions; however, continuous stimulation was more successful when contractions were absent. Hyperstimulation test results occurred in 21.5% of attempts and increased to 28.8% when bilateral, continuous stimulation was performed.
