Your Pregnancy After 35 : Labor and Delivery (part 7) - Nonstress Test, Biophysical Profile

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- Welcome to your First Trimester
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- Welcome to your Third Trimester

Tests You May Have

Tests done on your baby during labor provide your healthcare provider with a great deal of information. These tests include the nonstress test, the contraction stress test, the biophysical profile, fetal blood sampling, external fetal monitoring and internal fetal monitoring.

Nonstress Test (NST)

A nonstress test (NST) is a simple, noninvasive procedure done at 32 weeks of pregnancy or later; it is performed in the healthcare provider’s office or in the labor-and-delivery department at the hospital. This test measures how the fetal heart responds to the fetus’s own movements and evaluates fetal well-being in late pregnancy. It is commonly used in overdue and high-risk pregnancies. Information gained from a nonstress test gives reassurance your baby is doing OK.

Timing Contractions

It’s important for your healthcare provider to know how often contractions occur and how long each one lasts. Knowing this, he or she can decide if it’s time for you to go to the hospital. Contractions are timed to see how long a contraction lasts and how often contractions occur. Ask your healthcare provider how to time your contractions. There are two ways to do it.

Method 1—Start timing when the contraction starts, and time it until the next contraction starts. This is the most common method.

Method 2—Start timing when the contraction ends, and note how long it is until the next contraction starts.

While you’re lying down, a monitor is attached to your abdomen. Every time you feel the baby move, you push a button to make a mark on the monitor paper. At the same time, the fetal monitor records the baby’s heartbeat on the same paper.

Each time baby moves, the heart rate should accelerate by about 15 beats for about 15 seconds. When this occurs twice in a 20-minute period, the test is considered normal or reactive.

If the baby doesn’t move or if the heart rate does not react to movement, the test is called nonreactive. This doesn’t necessarily mean there is a problem—the baby may be sleeping. In more than 75% of nonreactive tests, the baby is healthy. When results are nonreactive, the test may be repeated in 24 hours or you may have additional tests, including a contraction stress test or a biophysical profile. See the discussion below.

Biophysical Profile (BPP)

A biophysical profile is a comprehensive test to help determine the fetus’s health status. The test is commonly performed in high-risk situations, overdue pregnancies or pregnancies in which the baby doesn’t move very much. It’s useful in evaluating an infant with intrauterine-growth restriction. A biophysical profile measures five areas, which are identified and scored:

fetal breathing movements

gross body movements

fetal tone

reactive fetal heart rate

amount of amniotic fluid

Ultrasound, external monitors and direct observation are all used to take the various measurements. Each area is given a score between 0 and 2; a total is obtained by adding the five scores together. The higher the score, the better the baby’s condition.

A baby with a low score may need to be delivered immediately. Your healthcare provider will evaluate the scores, your health and your pregnancy before making any decisions. If the score is reassuring, the test may be repeated at intervals. Sometimes the test is repeated the following day.

 
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