Diagnostic Value of Non Stress Test in Latent Phase of Labor and Maternal and Fetal Outcomes

Raouf, Shiva; Sheikhan, Fatemeh; Hassanpour, Shirin; Bani, Sarang; Torabi, Rogayye; Shamsalizadeh, Neda

doi:10.5539/gjhs.v7n2p177

Cited by 15 publications

(15 citation statements)

References 11 publications

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“…Many studies were from urban settings (urban: n = 16, rural: n = 1, both: 2), for 18 studies this could not be determined. Studies were on: admission tests and early intrapartum (CTG, n = 7, IA: 1, other methods, n = 6) [ 32 – 35 , 44 , 48 , 51 , 56 , 57 , 59 , 61 ], ongoing intrapartum FHR monitoring (IA, n = 8; CTG, n = 11) [ 26 – 28 , 30 , 31 , 36 – 39 , 41 , 43 , 45 – 47 , 50 , 53 , 58 ], adjunctive tests (n = 9) [ 39 , 41 – 43 , 45 , 46 , 49 , 52 , 58 ] and partograph (n = 5) [ 24 , 25 , 29 , 40 , 54 , 55 ] (Tables 1 – 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Studies were on low risk (n = 3) [ 44 , 57 , 60 ], high risk (n = 3) [ 34 , 48 , 56 ], and mixed-risk pregnancies(n = 1) [ 32 ]. Abnormal CTG traces were associated with intrapartum FHR abnormalities (foetal distress) [ 32 , 34 , 44 , 48 , 57 ], meconium-stained liquor [ 32 , 57 ]; low Apgar scores at 5 minutes [ 32 , 44 , 48 , 57 , 60 ], perinatal deaths [ 32 , 44 , 48 ], and admission to neonatal intensive care unit (NICU) [ 32 , 44 , 48 , 57 ]. Test performance of admission CTG varied across studies: PPV of 19% to 88%, while the NPV was between 88.6% to 100% [ 32 , 48 , 56 , 57 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…Only studies on admission CTG reported mode of delivery. Abnormal traces increased CS rates compared to reactive CTG traces (between 42.7% to 100% and 20.7% to 30%, respectively, p<0.05) [ 32 , 34 , 44 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

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Strategies for intrapartum foetal surveillance in low- and middle-income countries: A systematic review

et al. 2018

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BackgroundThe majority of the five million perinatal deaths worldwide take place in low-resource settings. In contrast to high-resource settings, almost 50% of stillbirths occur intrapartum. The aim of this study was to synthesise available evidence of strategies for foetal surveillance in low-resource settings and associated neonatal and maternal outcomes, including barriers to their implementation.Methods and findingsThe review was registered with Prospero (CRD42016038679). Five databases were searched up to May 1st, 2016 for studies related to intrapartum foetal monitoring strategies and neonatal outcomes in low-resource settings.Two authors extracted data and assessed the risk of bias for each study. The outcomes were narratively synthesised. Strengths, weaknesses, opportunities and threats analysis (SWOT) was conducted for each monitoring technique to analyse their implementation.There were 37 studies included: five intervention and 32 observational studies. Use of the partograph improved perinatal outcomes. Intermittent auscultation with Pinard was associated with lowest rates of caesarean sections (10–15%) but with comparable perinatal outcomes to hand-held Doppler and Cardiotocography (CTG). CTG was associated with the highest rates of caesarean sections (28–34%) without proven benefits for perinatal outcome. Several tests on admission (admission tests) and adjunctive tests including foetal stimulation tests improved the accuracy of foetal heart rate monitoring in predicting adverse perinatal outcomes.ConclusionsFrom the available evidence, the partograph is associated with improved perinatal outcomes and is recommended for use with intermittent auscultation for intrapartum monitoring in low resource settings. CTG is associated with higher caesarean section rates without proven benefits for perinatal outcomes, and should not be recommended in low-resource settings. High-quality evidence considering implementation barriers and enablers is needed to determine the optimal foetal monitoring strategy in low-resource settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Strategies for intrapartum foetal surveillance in low- and middle-income countries: A systematic review

et al. 2018

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“…Figure 5 shows that most common indication for LSCS in this study is Fetal distress either intrapartum or antepartum. Perinatal outcome is unfavourable in cases with non reactive NST as stated by Raouf S et al 12 Hence, continuous electronic fetal monitoring should be done in anticipation of fetal distress for cases with abnormal MBPP. Present study (100) 5 (15%) <0.05 Significant Figure 6 shows that the chances of LSCS in a patient with abnormal MBPP are statistically higher than in those with normal MBPP.…”

Section: Discussionmentioning

confidence: 99%

The role of modified biophysical profile in predicting perinatal outcome in high risk pregnancies

Borade

Sharma

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The goal of antepartum fetal surveillance is early identification of the compromised fetus and timely intervention when the fetus is at risk, but still in an uncompromised state. Modified Biophysical Profile (MBPP) includes Amniotic Fluid Index (AFI) and non stress test (NST). AFI is a marker of long term placental function and NST is a marker of short term fetal condition. The aim of this study is to assess the role of Modified Biophysical Profile in high risk pregnancies and assess perinatal outcome and to study the impact of NST and AFI individually in high risk pregnancies.Methods: 100 ANC patients with high risk factors were evaluated with modified biophysical profile 37 week onwards with non stress test (NST) for 20 mins and amniotic fluid index (AFI) with 4 quadrant technique. High risk pregnancies include preeclampsia, IUGR, oligohydramnios, postdated pregnancy, etc. and various parameters were assessed to determine perinatal and maternal morbidity. All parameters were statistically analyzed.Results: The above study states that need for LSCS, intrapartum fetal distress, meconium stained liquor, APGAR score, need for neonatal resuscitation and perinatal morbidity were definitely higher in cases with abnormal MBPP.Conclusions: Thus MBPP is an easy, cost effective and time saving measure and hence can be used as a primary antepartum fetal surveillance test to predict perinatal outcome and provide timely intervention in high risk pregnancies.

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“…4 Various studies have been carried out in past to correlate admission NST and neonatal outcome with near term/term gestation but a few studies conducted with aim to correlate both admission NST and umbilical cord arterial (UCA) pH with neonatal outcome including preterm gestation. [5][6][7][8][9][10][11] So we carried out this study to correlate the admission NST during labour and immediate post-partum UCA pH with neonatal outcome in ≥32 weeks pregnancy.…”

Section: Introductionmentioning

confidence: 99%

A study to correlate admission non stress test and immediate post-partum umbilical cord arterial pH with neonatal outcome

Nainani

Athwani

Avasthi

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Background: Continuous electronic fetal monitoring in labour has become a standard practice in developed countries; this may not be possible in low middle-income countries. So, this study was conducted to correlate admission non stress test (NST) and immediate post-partum umbilical cord arterial (UCA) pH with neonatal outcome.Methods: This prospective observational study was conducted at tertiary care centre in North India. After informed and written consent, 100 pregnant women with singleton live pregnancy of gestational age ≥32 weeks admitted in labour, were subjected to admission NST and immediately after delivery sample for UCA pH was taken. Clinically relevant neonatal outcome was correlated with admission NST and UCA pH. Appropriate statistical tests were used and p-value <0.05 taken as significant.Results: Admission NST was normal, suspicious, pathological in 67%, 27%, 6% subjects, respectively. Study found statistically significant correlation between admission NST and UCA pH with neonatal outcomes (i.e. fetal distress, need of advanced resuscitation, delayed oral feeding). Fetal distress was seen in 9 newborns, in these 8 delivered by CS and 1 required ventous application. Admission NST had high sensitivity (88.89%) and NPV (98.5%) for detection of fetal distress. The optimal cut off for pH and lactate was 7.25 and 2.55 mmol/L, respectively to predict fetal distress.Conclusions: Admission NST can be considered as a screening modality to detect fetus in distress and it showed good correlation with umbilical cord arterial pH for predicting short term neonatal outcome.

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Diagnostic Value of Non Stress Test in Latent Phase of Labor and Maternal and Fetal Outcomes

Cited by 15 publications

References 11 publications

Strategies for intrapartum foetal surveillance in low- and middle-income countries: A systematic review

Strategies for intrapartum foetal surveillance in low- and middle-income countries: A systematic review

The role of modified biophysical profile in predicting perinatal outcome in high risk pregnancies

A study to correlate admission non stress test and immediate post-partum umbilical cord arterial pH with neonatal outcome

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