Highmark commercial fetal non stress test

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An amniotic fluid index of more than 5 cm is thought to be an adequate volume of amniotic fluid. The modified biophysical profile is considered normal if the nonstress test is reactive and the amniotic fluid index is greater than 5 cm and abnormal if the nonstress test is nonreactive or the amniotic fluid index is 5 cm or less.

Doppler ultrasonography is used to assess the hemodynamic components of vascular impedence. Umbilical artery Doppler flow velocimetry has been adapted as a fetal surveillance technique because it is believed that flow velocity waveforms in the umbilical artery of fetuses with normal growth differ from those of fetuses with growth restriction.

The umbilical flow velocity waveform of a normally growing fetus has high-velocity diastolic flow, while in cases of intrauterine growth restriction, the umbilical artery diastolic flow is diminished. With extreme intrauterine growth restriction, the flow may be absent or even reversed. There is a high perinatal mortality rate among such pregnancies. The results of antepartum fetal surveillance have not definitively demonstrated improved perinatal outcome.

Therefore, all indications for antepartum testing should be considered somewhat relative. Usually, antepartum fetal surveillance is used in pregnancies with a high risk of antepartum fetal death. Some of the conditions in which testing is appropriate include the following:. Maternal conditions: antiphospholipid syndrome, poorly controlled hyperthyroidism, hemoglobinopathies such as hemoglobin SS, SC or S-thalassemia, cyanotic heart disease, systemic lupus erythematosus, chronic renal disease, type 1 diabetes mellitus and hypertensive disorders.

Pregnancy-related conditions : pregnancy-induced hypertension, decreased fetal movement, oligohydramnios, polyhydramnios, intrauterine growth restriction, post-term pregnancy, moderate to severe isoimmunization, previous fetal demise unexplained or recurrent risk and multiple gestation with significant growth discrepancy. Women at high risk for stillbirth should undergo antepartum fetal surveillance using the nonstress test, contraction stress test, biophysical profile or modified biophysical profile.

Initiation of testing at 32 to 34 weeks of gestation is appropriate for most pregnancies that are at increased risk of stillbirth. In pregnancies with multiple or particularly worrisome high-risk conditions, testing may be initiated as early as 26 to 28 weeks of gestation. When the clinical condition that prompted testing persists, a reassuring test should be repeated weekly or, depending on the test used and the presence of certain high-risk conditions, twice weekly until delivery.

Any significant deterioration in fetal activity requires fetal reevaluation, regardless of the amount of time that has elapsed since the last test.

An abnormal nonstress test or modified biophysical profile usually should be further evaluated by a contraction stress test or a full biophysical profile. Subsequent management should then be predicated on the results of the contraction stress test or biophysical profile, the gestational age, the degree of oligohydramnios if assessed and the maternal condition. Oligohydramnios, defined as no ultrasonographically measurable vertical pocket of amniotic fluid greater than 2 cm or an amniotic fluid index of 5 cm or less, requires depending on the degree of oligohydramnios, the gestational age and the maternal clinical condition delivery, or close maternal or fetal surveillance.

In the absence of obstetric contraindications, delivery of the fetus with an abnormal test result often may be attempted by induction of labor with continuous monitoring of the fetal heart rate and contractions. If repetitive late decelerations are observed, cesarean delivery generally is indicated.

Recent, normal antepartum fetal test results should not preclude the use of intrapartum fetal monitoring. Umbilical artery Doppler velocimetry seems to benefit only pregnancies complicated by intrauterine growth restriction. If used in this setting, decisions regarding timing of delivery should be made using a combination of information from the Doppler ultrasonography and other tests of fetal well-being, along with careful monitoring of maternal status.

Middle cerebral artery Doppler velocimetry should be considered an investigational approach to antepartum fetal surveillance. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

Techniques of Antepartum Fetal Surveillance. No late or significant variable decelerations. Preterm labor or certain patients at high risk of preterm labor. Preterm membrane rupture. History of extensive uterine surgery or classic cesarean delivery. Known placenta previa. Indications for Antepartum Fetal Surveillance. This series is coordinated by Michael J.

Arnold, MD, contributing editor. Continue Reading. More in AFP. In addition, non-stress tests are normally performed 26 to 30 weeks into pregnancy. This is because, in healthy babies, fetal heart rate increases with movement. A doctor will monitor heart rate, movement and contractions for about 20 to 30 minutes to help ensure the baby has ample oxygen supply.

The test is low risk for both the patient and the fetus. Therefore, the fetal NST can be performed frequently if needed. Not all pregnant women need to take a non-stress test. However, doctors recommend scheduling a test if the patient…. Finally, the test records heartbeat and contractions for 20 to 30 minutes and is ready for analysis. Baseline Variability, Accelerations and Decelerations are the most important parameters to monitor when analyzing a non-stress test.

Moreover, these parameters directly relate to the recorded fetal heart rate and uterus contractions. Therefore, c ontractions are generally recorded at the bottom. In this section, we will break down how to read and interpret a fetal NST correctly. Please watch this video for an in-depth explanation of this process.

The first step to reading an NST is to find an average fetal heart rate reading over 10 minutes. However, because we are monitoring fetal movement, we want the baseline heart rate to change in the long run. Most importantly, Accelerations help determine whether a fetal non-stress test is reactive or nonreactive. Healthcare providers want to ensure there are no decelerations during the non-stress test. Early Deceleration will generally indicate a healthy fetus.

We will break down each categorical finding below. To recap, non-stress tests play an important role in addressing fetal oxygen status and helping avoid high-risk pregnancy complications. To clarify, a failed or non-reactive test does not always indicate a reason for alarm.

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Not all pregnant women need to take a non-stress test. However, doctors recommend scheduling a test if the patient…. Finally, the test records heartbeat and contractions for 20 to 30 minutes and is ready for analysis. Baseline Variability, Accelerations and Decelerations are the most important parameters to monitor when analyzing a non-stress test.

Moreover, these parameters directly relate to the recorded fetal heart rate and uterus contractions. Therefore, c ontractions are generally recorded at the bottom. In this section, we will break down how to read and interpret a fetal NST correctly. Please watch this video for an in-depth explanation of this process. The first step to reading an NST is to find an average fetal heart rate reading over 10 minutes.

However, because we are monitoring fetal movement, we want the baseline heart rate to change in the long run. Most importantly, Accelerations help determine whether a fetal non-stress test is reactive or nonreactive.

Healthcare providers want to ensure there are no decelerations during the non-stress test. Early Deceleration will generally indicate a healthy fetus. We will break down each categorical finding below. To recap, non-stress tests play an important role in addressing fetal oxygen status and helping avoid high-risk pregnancy complications. To clarify, a failed or non-reactive test does not always indicate a reason for alarm.

For example, the fetus may have been sleeping during the test. However, it may dictate more tests and further monitoring during the pregnancy. But most importantly, providers thoroughly discuss the test results with patients and address all concerns. What is a Non-Stress Test? Who Needs a Non-Stress Test? A reactive nonstress test is considered reassuring regardless of the length of observation time needed.

However, if the test is extended to 40 minutes and your baby's nonstress test results are nonreactive, your health care provider will likely do another prenatal test to further check your baby's health. For example:. Other possible causes of a nonreactive nonstress test result, besides the fetus being inactive or asleep, include decreased oxygen fetal hypoxia , maternal smoking, maternal use of medications, and fetal neurological or cardiac anomalies. Rarely, during a nonstress test, problems with a baby's heart rate are detected that require further monitoring or treatment.

Be sure to discuss the results of your nonstress test with your health care provider and what they might mean for you and your baby. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Sections for Nonstress test About. Overview A nonstress test is a common prenatal test used to check on a baby's health. Request an Appointment at Mayo Clinic.

By Mayo Clinic Staff. Share on: Facebook Twitter. Show references Gabbe SG, et al. Antepartum fetal evaluation. In: Obstetrics: Normal and Problem Pregnancies. Philadelphia, Pa. Accessed Feb. DeCherney AH, et al. Assessment of at-risk pregnancy. New York, N. Miller DA. Nonstress test and contraction stress test. Frequently asked questions. Pregnancy FAQ Special tests for monitoring fetal health.