Diagnostic Procedures in Pregnancy

Overview

• Discussed diagnostic procedures: Nonstress Tests (NST), Biophysical Profiles (BPP), and Contraction Stress Tests (CST).
• Shared personal experiences with NST and BPP at the end of the presentation.

Nonstress Test (NST)

Definition

• Nonstress: No stress is applied to the baby or mother; it's purely observational.
• Monitors baby's heart rate and movements inside the womb.

Procedure

• Equipment: Tocometer (measures uterine stress/contractions) and a fetal heart rate transducer or Doppler.
• Mother may be given a button to press when she feels the baby move; marks the fetal heart rate strip.

Results Interpretation

• Reactive NST (desired result):
  • Baby's heart rate increases by 15 bpm, sustained for at least 15 seconds, two times within 20 minutes.
  • Indicates good oxygenation.
• Non-Reactive NST:
  • Insufficient accelerations of fetal heart rate.
  • Indicates need for further testing.

Common Uses

• Decreased fetal movement.
• Routine checks for advanced maternal age, pregnancy complications, or post-date pregnancies.

Biophysical Profile (BPP)

Components

• Combines NST with ultrasound assessments.
• Evaluates five criteria:
  1. Fetal heart rate (NST).
  2. Fetal breathing movements.
  3. Gross body movements.
  4. Fetal tone (extension and flexion of head/neck).
  5. Amniotic fluid volume.

Scoring

• Each component scores 2 or 0 points.
• Total score of 8-10 is normal; below 8 indicates possible fetal hypoxia.
• Possible action: delivery if hypoxia is suspected.

Contraction Stress Test (CST)

Definition

• Assesses fetal response to induced contractions.
• Less common due to availability of ultrasounds but important to know.

Procedure

• Induce contractions via nipple stimulation or administering oxytocin.
• Monitor fetal heart rate during contractions.

Results Interpretation

• Negative CST (desired result):
  • Three contractions in 10 minutes without late decelerations.
• Positive CST:
  • Late decelerations in 50% or more of contractions.
  • Suggests placental insufficiency; not desirable.

Key Comparisons

• NST: Non-invasive, want reactive/positive result.
• CST: Induces stress, potential risk of preterm labor, want negative result.
• BPP: Uses ultrasound for comprehensive fetal assessment.

Personal Experience

• Author had bi-weekly NSTs due to genetic condition.
• Daughter often had non-reactive NSTs and once led to a BPP score of 6, resulting in delivery via C-section.
• Son consistently had reactive NSTs, indicating good health.

Conclusion

• Understanding these tests helps in assessing fetal well-being.
• Engaging with this content can enhance preparedness in nursing practice.

Remember to subscribe and engage with the content by sharing it with peers. Your feedback is valuable!