ANTENATAL NON-STRESS TEST IN LOW RISK AND HIGH-RISK PREGNANCIES: EVOLVING ROLE OF NST IN IMPROVING PERINATAL OUTCOMES

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Dr. Shuchita Batra
Dr. Garima Yadav
Dr. Pratibha Singh
Dr. Meenakshi Gothwal
Dr. Priyanka Kathuria

Abstract

Background: Nonstress Test (NST) involves interpretation of foetal heart rate patterns in the background of clinical scenario. At least 50% of antenatal deaths occur in low risk population. Antenatal NST provides us opportunity to pick up at-risk foetuses, intervene and improve perinatal outcome.



Objective: To determine if routine antenatal NST can improve perinatal outcome, and compare the results in both low and high-risk term pregnancies



Materials and methods: A prospective cohort study was conducted in Department of Obstetrics and Gynaecology, AIIMS, Jodhpur from May 2017 to April 2018. Atotal of 449 cases were included; Low risk cases – 268, high risk cases – 181. All included women underwent antenatal NST from 37 weeks onwards at every visit. These NSTs were compared with foetal and maternal outcome.



Results: During antenatal period, normal and suspicious NST is highly suggestive of good perinatal outcome. Foetuses with pathological antenatal NST showed increased chance of foetal distress. Also, pathological NST indicated more chances of caesarean delivery, low 1-minute APGAR scores, meconium staining, and need of resuscitation (p< 0.05). There were no perinatal deaths.



Conclusion: Antenatal NST is a tool to be used wisely and judiciously after case selection. It can help us in selecting patients needing high index of care, specifically in busy labour room settings with inadequate staffing and low doctor to patient ratio. Patients with pathological antenatal NST in both low risk and high-risk pregnancies deserve equal and efficient further foetal monitoring and early delivery. There is no proven benefit of doing antenatal NSTs in otherwise low risk women except the ones having decreased foetal movements or prior foetal demise.



Keywords: Antenatal; Non stress test; Caesarean section; Perinatal outcomes; APGAR

Published Jul 26, 2020

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