Diagnostic Procedures in Pregnancy

Overview

Presenter: Meris
Focus on three diagnostic procedures: Nonstress Tests (NST), Biophysical Profiles (BPP), and Contraction Stress Tests (CST)
Personal experience shared at the end

Purpose: Monitor baby's well-being without causing stress to baby or mother
Procedure:
- Tocometer to measure uterine contractions
- Fetal Heart Rate (FHR) ultrasound transducer/Doppler
- Sometimes a button for mother to press when baby moves
Results:
- Reactive: Baby's heart rate increases by 15 bpm for at least 15 seconds twice in 20 minutes
- Non-reactive: No sufficient acceleration, requires further testing
Indications: Advanced maternal age, pregnancy complications, post-date pregnancy, decreased fetal movement

Combination of NST and ultrasound to assess baby's well-being
Components and Scoring (Each scored 0 or 2):
- Fetal heart rate based on NST
- Fetal breathing movements (at least one in 30 seconds)
- Gross body movements (at least three)
- Fetal tone (extension and flexion of head and neck)
- Amniotic fluid volume (at least one pocket > 2 cm)
Interpretation:
- 8-10: Normal, reassuring
- Less than 8: Indicative of fetal hypoxia, potential need for delivery

Purpose: Monitor baby's response to contractions induced through nipple stimulation or oxytocin
Rarely used, due to risk of preterm labor and availability of ultrasounds
Procedure:
- Tocometer and FHR transducer
- Induce contractions
Results:
- Negative: No late decelerations in three contractions within 10 minutes (Good)
- Positive: Late decelerations in 50% or more contractions, indicates potential placental insufficiency (Bad)

Meris had NSTs twice a week for both children
Daughter failed most NSTs, resulting in a BPP and ultimately a C-section despite being healthy
Son passed all NSTs with ease