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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Interpretation and outcome of various antenatal fetal testing methods

Interpretation and outcome of various antenatal fetal testing methods
Name Components Results/
scoring		 False negative False positive Stillbirth rate within 1 week of a normal test result* References
Contraction stress test (oxytocin challenge test)

Continuous FHR monitoring

At least 3 contractions of ≥40s duration within 10 minutes

Negative: No late or significant variable decelerations

Positive: Late decelerations following ≥50% of contractions, even if there are <3 contractions in 10 minutes

Equivocal - suspicious: Intermittent late decelerations or significant variable decelerations

Equivocal - hyperstimulatory: Decelerations with contractions occurring more frequently than every 2 minutes or lasting >90s

Unsatisfactory: <3 contractions in 10 minutes or uninterpretable FHR tracing		 0.04% 35 to 65% 0.3/1000 [1,2]
Nonstress test

Continuous FHR monitoring

FHR accelerations: ≥32w: Reaching 15 bpm above baseline and lasting ≥15s

<32w: Reaching 10 bpm above baseline and lasting ≥10s

Reactive: ≥2 accelerations within 20 minutes (may be extended to 40 minutes)

Nonreactive: <2 accelerations in 40 minutes		 0.2 to 0.65% 55 to 90% 1.9/1000 [1,3-7]
Biophysical profile Presence or absence of 5 components within 30 minutes:
  • Reactive NST
  • ≥1 episode of fetal breathing movements lasting ≥30s
  • ≥3 discrete body or limb movements
  • ≥1 episode of extremity extension with return to flexion or opening or closing of a hand
  • Maximum vertical AF pocket >2 cm
Each component is assigned a score of 2 points if all criteria for the component are present and 0 points if all criteria for the component are not present; maximum score is 10/10
  • Normal: ≥8/10 or 8/8 excluding NST
  • Equivocal: 6/10
  • Abnormal: ≤4/10
0.07 to 0.08% 40 to 50% 0.8/1000 [8-10]
Modified biophysical profile
  • NST
  • Maximum vertical AF pocket >2 cm

Normal: Reactive NST and maximum vertical AF pocket >2 cm

Abnormal: Nonreactive NST and/or maximum vertical AF pocket ≤2 cm		 0.08% 60% 0.8/1000 [11-14]
s: seconds; NST: nonstress test; AFI: amniotic fluid index; FHR: fetal heart rate; w: weeks; bpm: beats per minute.
* Stillbirth rate was derived from large series and corrected for lethal congenital anomalies and unpredictable causes of fetal demise.
References:
  1. Freeman RK, Anderson G, Dorchester W. A prospective multi-institutional study of antepartum fetal heart rate monitoring. II. Contraction stress test versus nonstress test for primary surveillance. Am J Obstet Gynecol 1982; 143:778.
  2. Lagrew DC Jr. The contraction stress test. Clin Obstet Gynecol 1995; 38:11.
  3. Platt LD, Walla CA, Paul RH, et al. A prospective trial of the fetal biophysical profile versus the nonstress test in the management of high-risk pregnancies. Am J Obstet Gynecol 1985; 153:624.
  4. Lavery JP. Nonstress fetal heart rate testing. Clin Obstet Gynecol 1982; 25:689.
  5. Phelan JP, Cromartie AD, Smith CV. The nonstress test: the false negative test. Am J Obstet Gynecol 1982; 142:293.
  6. Rochard F, Schifrin BS, Goupil F, et al. Nonstressed fetal heart rate monitoring in the antepartum period. Am J Obstet Gynecol 1976; 126:699.
  7. Boehm FH, Salyer S, Shah DM, Vaughn WK. Improved outcome of twice weekly nonstress testing. Obstet Gynecol 1986; 67:566.
  8. Manning FA, Morrison I, Harman CR, et al. Fetal assessment based on fetal biophysical profile scoring: experience in 19,221 referred high-risk pregnancies. II. An analysis of false-negative fetal deaths. Am J Obstet Gynecol 1987; 157:880.
  9. Manning FA, Morrison I, Lange IR, et al. Fetal assessment based on fetal biophysical profile scoring: experience in 12,620 referred high-risk pregnancies. I. Perinatal mortality by frequency and etiology. Am J Obstet Gynecol 1985; 151:343.
  10. Dayal AK, Manning FA, Berck DJ, et al. Fetal death after normal biophysical profile score: An eighteen-year experience. Am J Obstet Gynecol 1999; 181:1231.
  11. Miller DA, Rabello YA, Paul RH. The modified biophysical profile: antepartum testing in the 1990s. Am J Obstet Gynecol 1996; 174:812.
  12. Clark SL, Sabey P, Jolley K. Nonstress testing with acoustic stimulation and amniotic fluid volume assessment: 5973 tests without unexpected fetal death. Am J Obstet Gynecol 1989; 160:694.
  13. Nageotte MP, Towers CV, Asrat T, et al. The value of a negative antepartum test: contraction stress test and modified biophysical profile. Obstet Gynecol 1994; 84:231.
  14. Vintzileos AM, Knuppel RA. Multiple parameter biophysical testing in the prediction of fetal acid-base status. Clin Perinatol 1994; 21:823.
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