Nonstress Test

If fetal compromise is suspected, the nonstress test (NST) is the first assessment of fetal well-being:

■ The mother is placed in a left lateral, supine position.

■ A continuous FHR tracing is obtained using external Doppler equipment.

■ The heart rate changes that result from the fetal movements are determined:

■ A normal fetal response during each fetal movement is an acceleration in fetal heart rate of > 15 bpm above the baseline for at least 15 seconds.

■ If at least two such accelerations occur in a 20-minute interval, the fetus is deemed healthy and the test is reactive.

■ If an NST is nonreactive, it should be followed by a biophysical profile (BPP).

The physiologic basis for using the BPP lies in the fact that coordinated fetal activities (i.e., breathing and movement) require an intact, nonhypoxic central nervous system.

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