Evaluation of non-stress test as predictor of perinatal outcome in high risk and low risk pregnancy: a prospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232289Keywords:
Bio-physical Profile, High Risk Pregnancy, Non-stress Test (NST), Perinatal OutcomeAbstract
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.
References
Panchal VP. Colour doppler and non stress test- useful diagnosic tool for foetal surveillance in high risk pregnancy. IJSR. 2014;3(2):347-8.
Himabindu P, Sundari MT, Pavani S. Evaluation of non stress test in monitoring high risk pregnancies. IOSR-J Dent Med Sci. 2015;14(4):40-2.
American college of Obstetricians and Gynecologists ACOG Practice Bulletin (9, October 1999) Antepartum foetal surveillance. Int J Gynecol Obstet. 2000;68(2):175-86.
Jamatia A, Malhotra V, Nanda S, Gupta S, Sangwan N, Bhuriya V. Role of nonstress test in improving the perinatal outcome in pregnancies complicated by preeclampsia. Int J Clin Obstet Gynaecol. 2019;3(2):30-5.
Arias F, Daftary SN, Bhide AG, Arulkumaran S. Arias’ practical guide to high-risk pregnancy and delivery: a South Asian perspective. 3rd edn. Elsevier India; 2011:16-29.
Radhika P, Lavanya R. Fetal Doppler versus NST as predictors of adverse perinatal outcome in severe preeclampsia and fetal growth restriction. J Obstet Gynecol India. 2006;56:134-8.
Cunningham FG. Intrapartum Assessment. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY, eds. Williams Obstetrics. 23rd edn. USA: McGraw Hill; 2010;410-414.
Kaur N, Jindal P. Study of ‘nonstress test at admission’ and its corelation with maternal and fetal outcome. J South Asian Feder Obstet Gynecol. 2018;10(3):161-6.
Phillips PWD, Towell ME. Abnormal fetal heart rate associated with congenital abnormalities. Br J Obstet Gynaecol. 1980;87:(4):270-4.
Pirhadi M. Effect of acupressure on non-stress test (NST) results: a randomized-controlled trial study. Int J Pediatr. 2015;3(5.2):981-6.
Singh S, Premi HK, Gupta R. The role of non-stress test as a method to evaluate the outcome of high-risk pregnancy: a tertiary care center experience. Int Surg J. 2020;7:1782-7.
Ratnam SS, Bhasker Rao K, Arulkumran S. Obstetrics and Gynaecology for post graduates. 1st edn. Chennai: Orient Longman; 1992:115-116.
Denny JM, Waters TP, Gorman R, Pollock M, Sciscione AC. Choice of antenatal testing significantly effects a patient work obligation. J Perinatol. 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 Obstet Gynaecol. 2012;51(3):397-401.
Verma A, Shrimali L. Impact of admission non stress test as a screening procedure on perinatal outcome. Int J Med Pharm Sci. 2012;3(5):6-10.
Bano I, Noor N, Motwani L, Arshad Z. Comparative study of nonstress test and fetal acoustic stimulation test in assessment of fetal well-being. J South Asian Feder Obstet Gynaecol. 2011;3(1):6-9.
Lohana RU, Khatri M, Hariharan C. Correlation of non stress test with fetal outcome in term pregnancy (37-42 Weeks). Int J Reprod Contracept Obstet Gynecol. 2013;2:639-45.
Sekhavat L, Tabatabaei A. The effect of different maternal position on nonstress test NST). World Applied Sci J. 2014;32(5):853-6.
Mehta L, Vyas M, Chauhan N, Shah A, Varia K. Role of non-stress test and Doppler in assessment of perinatal outcome in highrisk pregnancy. IJSR. 2013;2(8):379-380.
Verma U, Garg R, Rani R, Jain M, Pathak A. Comparative study of foetal colour doppler versus non-stress test as a predictor of perinatal outcome in high risk pregnancy. Obstet Gynecol Int J. 2015;2(6):216-9
Das V, Katiyar N, Malik GK. Role of admission test. J Obstet Gynecol India. 2001;51(1):48-50.
Phelan JP. The nonstress test: a review of 3,000 tests. Am J Obstet Gynecol. 1981;139(1):7-10.
EL-Edessy MS, Nasr AA, Mustafa FA, El-Rashedy MI, Abd El-Sattar M, Saleh M. High risk pregnancy outcomes in upper Egypt: umbilical artery doppler versus non stress test. Am J Res Commun. 2014;2(1):75-85.
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. Glob J Health Sci. 2015;7(2):177-82.
EL-Edessy MS, Nasr AA, Mustafa FA, El-Rashedy MI, Abd El-Sattar M, Saleh M. High risk pregnancy outcomes in upper Egypt: Umbilical artery doppler versus non stress test. Am J Res Commun. 2014;2(1):75-85.
Chaudhary PK, Bhati BS, Bishnoi S. Role of non stress test in monitoring antenatal fetal well being in high risk pregnancy. IJOGR. 2020;7(2):201-6.