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  IN THIS Article
 ::  Abstract
 ::  Introduction
 ::  Material and method
 ::  Results
 ::  Discussion
 ::  References

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ORIGINAL ARTICLE
Year : 1990  |  Volume : 36  |  Issue : 2  |  Page : 104-5

Predictive value of the nonreactive nonstress test in evaluating neonatal outcome.


Department of Obstetrics and Gynaecology, Seth G. S. Medical College, Bombay, Maharashtra.

Correspondence Address:
Department of Obstetrics and Gynaecology, Seth G. S. Medical College, Bombay, Maharashtra.


  ::  Abstract

High-risk pregnancies were followed up with antepartum foetal heart testing, in terms of perinatal mortality, Apgar score and incidence of caesarian section for foetal distress to look for the significance of a nonreactive nonstress test in 143 cases. The mean sensitivity was 65.64%, mean positive predictive value was 23.12%, and mean false positive rate was 76.87% for the nonreactive test results.

How to cite this article:
Bhide A, Bhattacharya M S. Predictive value of the nonreactive nonstress test in evaluating neonatal outcome. J Postgrad Med 1990;36:104


How to cite this URL:
Bhide A, Bhattacharya M S. Predictive value of the nonreactive nonstress test in evaluating neonatal outcome. J Postgrad Med [serial online] 1990 [cited 2019 Sep 19];36:104. Available from: http://www.jpgmonline.com/text.asp?1990/36/2/104/864




  ::   Introduction Top

Electronic foetal monitoring is a relatively recent development in the field of perinatology. While the implications of a reactive non-stress test are will known, the same cannot be said about a non-reactive non-stress test. The following study was carried out in a high-risk pregnant population to gain an insight into the problem. A non-reactive non-stress test was a sign of bad omen in a fair proportion of cases.

  ::   Material and method Top

Hundred and forty-three high-risk cases were followed up with the non-stress testing. Corometrics-112 machine was used. The test was done for 20 minutes; extendable upto 40 minutes to call it non-reactive. Criteria described by Evertson et al[1] were used to classify the strip as non-reactive. The neonatal outcome was assessed using three criteria-a) neonatal survival, b) Apgar scores at 5 minutes and c) incidence of caesarean sections done for foetal distress. The test results in the preceding 7 days of delivery were considered. The largest high-risk group was pregnancy induced hypertension.

  ::   Results Top

A total of 287 tests were carried out in 143 cases. The last test was reactive in 95, and non-reactive in 48 cases.
a) Perinatal outcome: The results are shown in [Table - 1]. A total of 13 mortalities occurred, out of which 8 were from the non-reactive group.
b) Apgar scores: Five minute Apgar scores of less than 7 were taken as abnormal [2]. A total of 17 babies were found to be depressed at birth, of which 13 were from the non-reactive group. The results are shown in
c) Caesarean section for foetal distress: As shown in [Table - 3], of caesarean sections done for foetal distress 10 were from the non-reactive group. Ninety-four patients underwent vaginal delivery and remaining 34 underwent caesarian sections for causes other than foetal distress.

  ::   Discussion Top

Non-stress test is an accepted method of monitoring high risk pregnancies. One of the objections to the test is that it has a high false positive rate; in other words, it cannot predict adverse foetal outcome. In our series, the mean false positive rate was 76.87% with 23.13% of abnormal results correctly predicted, and these figures closely approximate to those quoted in the literature.3 In our opinion this is an asset of the test since if the false positive rate is very low, majority of the cases will have an abnormal outcome. Thus the test would have failed us in intervening early enough to avoid a poor outcome. In our view, a non-reactive non-stress test is a bad omen, signifying a higher incidence of foetal distress, depressed neonates and a higher perinatal mortality.

  ::   References Top

1. Cloharty JP, Stark AR. In: "Manual of Neonatal Care", 2nd Edition, Little, Boston. Toronto: Brown and Co; 1985, pp 77-78.  Back to cited text no. 1    
2.Evertson LR, Gauthier RJ, Schifrin BS, Paul RH. Anteparturn fetal heart rate testing - 1: Evolution of the non-stress test Amer J Obstet & Gynaecol 1979; 133:29-33.  Back to cited text no. 2    
3.Weingold A, Yonekura ML, O'Kieffe L. Non-stress testing. Amer J Obstet & Gynaecol 1980; 138:195-202.   Back to cited text no. 3    

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow