A prenatal non-stress test is a relatively common test done in the third trimester of your pregnancy to evaluate how your baby is doing by measuring the heart rate. It’s common because there is very little risk to the mother or the baby and the results from the test can often be used to evaluate if the baby is being unduly stressed in the uterine environment.The test is only performed after 28 weeks gestation because before that the baby isn’t old enough to meet the test protocols and the doctor wont get an accurate result.
The mother arrives for the test very soon after having eaten and emptying her bladder. Right after a meal there is less of a chance that the baby is napping due to the increased activity of the mother and the increased amount of sugar available in the blood stream.
During the test a strap is placed over the mother belly to monitor the baby’s heart rate. Sometimes two straps are used in order to ensure the monitoring is accurate and picked up by the machine.
The test measures the anticipated increase in the baby’s heart rate after the baby has moved in the uterus. The expectation is that with movement the baby’s heart rate will increase to accommodate for the increased muscle movement. In a baby who is under oxygen debt there will not be the expected heart rate increases.
This test is completely non-invasive and doesn’t hurt the mother or the baby.
If the test doesn’t show at least two heart rate increases that last over 20 seconds in a 20 minute period of time the assumption is that the baby is napping and another test is done within an hour.
The physician wont wait to repeat a nonreactive prenatal non-stress test until the following day but rather will repeat it quickly to determine if the child requires intervention to prevent complications.
- Typically the prenatal Non-Stress Test is ordered during the third trimester in several instances:
- If you are over 41 weeks and dont have a scheduled delivery
- If you sense the baby isnt moving as much as he has been
- If your doctor suspects or knows there is a problem with the sufficiency of the placenta
- Or if you are at high risk for another reason
When a prenatal non-stress test is reactive or normal then research has shown that in most of these cases the baby isn’t at high risk for death in utero within the following five days. This is why the test should be repeated every four to five days. But, as with all tests, this is an estimation of what will happen. This test may overlook babies who require greater monitoring but may give a false negative for babies who dont require the extra care they receive.
When a negative prenatal non-stress test is determined the physician may order a contraction stress test. In this case a diluted amount of oxytocin is administered through an IV. There is enough to cause mild contractions but not induce labor. In fact, many mothers don’t even feel these contractions. However, in the uterus the baby does. When the mother has 3 contractions in 10 minutes and the baby’s heart rate doesn’t decelerate then the test is considered negative.
A reactive or normal prenatal non-stress test will tell your doctor that the blood flow and oxygen to the baby is adequate to meet the needs of your baby. A non-reactive test may indicate that your baby isn’t receive adequate amounts of oxygen or that the baby is sleeping or that mom is taking medication or nonprescription drugs that are interfering with the results. You and your doctor can determine what the next steps you will take if your baby has a nonreactive non-stress test.
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