CH12. ANTEPARTUM FETAL TESTING
(NONSTRESS TEST, AMNIOTIC FLUID
INDEX, BIOPHYSICAL PROFILE,
CONTRACTION STRESS TEST, AND
UMBILICAL ARTERY DOPPLER EXAM
QUESTIONS AND ANSWERS
Biophysical profile - ANSWER-5 components
1. NST
2. Amniotic fluid level
3. Fetal extremity tone
4. Fetal gross body movement
5. Fetal breathing air movement
score of 8-10 highly reassuring TX: management is to repeat the test weekly or as
indicated
score of 4-6 worrisome TX: Deliver if >36 weeks or repeat biophysical profile in 12-
24 hours if <36 weeks. alternative is try CST
score of 0-2 highly predictive of fetal hypoxia with low probability of false positive TX:
prompt delivery regardless of gestational age
A modified BPP includes only the NST and Amniotic fluid volume. - its predictive
value is as high as a complete BPP
Contraction stress test - ANSWER-assess the ability of the fetus to tolerate transitory
decrease in intervillous blood flow that occur with uterine contractions. it uses both
external FHR and contraction monitoring devices and is based on the presence or
absence of late decelerations.
These are gradual decreases in FHR below the baseline with onset to nadir of
>30seconds. the deceleartion onset and end is delayed in relation to contractions.
If 3 contractions in 10 min are not spontaneously present, they may be induced with
either IV oxytocin or nipple stimulation.
this test is rarely performed, but the most common indication is BPP 4-6.
Negative CST - Requires absecne of any late deceleration with contraction --
reassuring for fetal well being
Positive CST - this requires late declerations associated with at least 50% of
contractions.
TX: Prompt delivery
(NONSTRESS TEST, AMNIOTIC FLUID
INDEX, BIOPHYSICAL PROFILE,
CONTRACTION STRESS TEST, AND
UMBILICAL ARTERY DOPPLER EXAM
QUESTIONS AND ANSWERS
Biophysical profile - ANSWER-5 components
1. NST
2. Amniotic fluid level
3. Fetal extremity tone
4. Fetal gross body movement
5. Fetal breathing air movement
score of 8-10 highly reassuring TX: management is to repeat the test weekly or as
indicated
score of 4-6 worrisome TX: Deliver if >36 weeks or repeat biophysical profile in 12-
24 hours if <36 weeks. alternative is try CST
score of 0-2 highly predictive of fetal hypoxia with low probability of false positive TX:
prompt delivery regardless of gestational age
A modified BPP includes only the NST and Amniotic fluid volume. - its predictive
value is as high as a complete BPP
Contraction stress test - ANSWER-assess the ability of the fetus to tolerate transitory
decrease in intervillous blood flow that occur with uterine contractions. it uses both
external FHR and contraction monitoring devices and is based on the presence or
absence of late decelerations.
These are gradual decreases in FHR below the baseline with onset to nadir of
>30seconds. the deceleartion onset and end is delayed in relation to contractions.
If 3 contractions in 10 min are not spontaneously present, they may be induced with
either IV oxytocin or nipple stimulation.
this test is rarely performed, but the most common indication is BPP 4-6.
Negative CST - Requires absecne of any late deceleration with contraction --
reassuring for fetal well being
Positive CST - this requires late declerations associated with at least 50% of
contractions.
TX: Prompt delivery
