Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing

Tan, Kok Hian; Smyth, Rebecca

doi:10.1002/14651858.cd002963

Cited by 24 publications

(7 citation statements)

References 35 publications

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“…In a study where the FAST was performed in a low risk population without carrying out an NST, 97% of women perceived sound provoked fetal movements [8]. Sensitivities of 8-94%, specificities of 89-97% and negative predictive values of 98-100% of the FAST have been reported in other studies [11][12][13][14] In the present study, compared to the NST, the FAST had less sensitivity ( 93 % vs 100 %, p = 0.01 ) better specificity ( 79 % vs 45 %, p = 0.001 ) better positive predictive value ( 67 % vs 50 %, p = 0.02 ) similar negative predictive values ( 96 % vs 100 %, p > 0.5 ) and better accuracy ( 83% vs 69%, p = 0.05 ) in predicting neonatal asphyxia ( 5 minute Apgar score < 7) if the baby was delivered within 24 hours after the test. The positive predictive value of the FAST has been found to be low with rates of 14% [21] to 55% [11] being reported.…”

Section: Discussionmentioning

confidence: 90%

“…Maternal perception of fetal movements in response to FAST has a higher sensitivity [8]. In both high and low risk pregnancies, it has been found to be a useful screening test [8][9][10][11][12][13]. Several studies have shown that the FAST can convert false positive (non-reactive) non-stress tests (NST) to reactive ones and also shorten the time duration that a NST needs to be carried out [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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The fetal acoustic stimulation test: a reliable and cost effective method of antepartum fetal monitoring

Batcha

Goonewardene

2009

Ceylon Med. J.

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Rationale A healthy foetus, if exposed to external sound stimulation, often responds with vigorous movements which can be felt by the mother. A hypoxic foetus usually does not show this response.Objectives To evaluate the fetal acoustic stimulation test (FAST) in antepartum fetal monitoring.Design and Setting Prospective interventional study carried out at the Teaching Hospital, Galle.Method An initial non-stress test (NST) followed by a FAST using the Corometric TM model 146 was carried out in 423 high risk pregnant women. The response to FAST was assessed and compared with the NST. A repeat NST was recorded in women who had an initial non-reactive NST. The results of the NST and FAST were compared with the fetal outcome if the woman delivered within 24 hours.Outcome measures Maternal perception of fetal movements after FAST, results of NST before and after FAST, and the babies' 5 minute Apgar scores if delivered within 24 hours of the FAST.Results Of the women, 349 ( 82.5 %) noticed fetal movements after FAST. Of the 167 women who complained of absent or reduced fetal movements, 67% felt fetal movements after FAST. Ninety one had a nonreactive NST and 43 (47 %) became reactive after FAST. Compared to the NST, the FAST had less sensitivity ( 93 % vs 100 %, p = 0.01 ), better specificity ( 79 % vs 45 %, p = 0.001 ), better positive predictive value ( 67 % vs 50 %, p = 0.02 ), similar negative predictive values ( 96 % vs 100 %, p > 0.05 ) and better accuracy ( 83% vs 69% , p = 0.03) in predicting neonatal asphyxia ( 5 minute Apgar score < 7) if the baby was delivered within 24 hours after the test.Conclusion The FAST is a reliable, cost effective screening test for antepartum fetal monitoring. It significantly reduces the false positive (non-reactive ) NST and has a good negative predictive value.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The fetal acoustic stimulation test: a reliable and cost effective method of antepartum fetal monitoring

Batcha

Goonewardene

2009

Ceylon Med. J.

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“…The 2015 Cochrane review 'Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a nonreassuring fetal heart rate trace' 9 did not show any reduction in the likelihood of caesarean section, instrumental delivery or increase in normal birth with use of FSL or fetal pH in conjunction with CTG in labour. Indeed there is no evidence that any of the supplementary tests, including fetal oximetry, 5 fetal ECG, 6 vibroacoustic stimulation 7 and near-infrared spectroscopy, 8 reduce the likelihood of caesarean section. Although some modalities (eg fetal pulse oximetry) may be associated with a reduction in CS for FD, this is offset by an increase in CS for failure to progress or CS for other reasons.…”

Section: Discussionmentioning

confidence: 99%

Involving the consultant before fetal blood sampling

Lowe

Beckmann

2016

Aust NZ J Obst Gynaeco

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Background: Fetal scalp lactate (FSL) is used when the cardiotocography (CTG) is not normal in an attempt to reduce the false-positive rate and the likelihood of unnecessary intervention. Whilst the test has almost a 100% negative predictive value, the positive predictive value of this test is very low. Aims: To measure the effect of introducing consultant obstetrician review of every abnormal CTG prior to the decision to perform FSL. Materials and Methods: A retrospective cohort study was performed using routinely collected de-identified data. Mode of birth outcomes for women who had a continuous CTG in labour were compared in two equal time periods, 12 months before and after a change in hospital policy. Change in hospital policy dictated that FSL was only performed on a pathological CTG after consultant obstetrician review of the CTG. Results: Consultant obstetrician review of CTG prior to FSL was associated with fewer FSL performed (1.7% vs 3.5%; P ≤ 0.01), fewer babies acidaemic at birth pH < 7.1 (0.8% vs 2.2%; P < 0.01), fewer caesarean sections for presumed fetal distress (CS for FD) (6.6% vs 8.1%; P = 0.05) and fewer instrumental births (17.6% vs 20%; P = 0.04). When adjusted for confounders, the change in policy was independently associated with a reduced likelihood of CS for FD (adjusted odds ratios = 0.78 (0.63-0.97); P = 0.03). Conclusions: A hospital policy whereby a consultant obstetrician reviews abnormal CTGs prior to performing FSL may help to increase the pretest probability and reduce the rate of CS for FD, as well as instrumental birth and unnecessary FSL.

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“…The incidence of these patterns can be reduced by 48 % by these method, increasing the specificity of the CTG ( [96]; EL IIa).…”

Section: Fetal Stimulationmentioning

confidence: 99%

S1-Guideline on the Use of CTG During Pregnancy and Labor

Schneider¹

2014

Geburtshilfe Frauenheilkd

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The aim of this consensus paper is to standardize the use of cardiotocograms (CTG) in fetal monitoring using an evidence-based approach. Recommended standards take the impact of disturbances and other influencing variables on the CTG into account, use standard definitions and objective assessment methods, and look at upstream diagnostic procedures and adjunct monitoring methods. The target audience for this consensus paper are all professionals who use CTG readings to monitor pregnancies and childbirth, most notably gynecologists and midwives. Method: This guideline was compiled with particular reference to and in consideration of previous recommendations [85], the FIGO guidelines [59, 82], and the guidelines of the Royal College of Obstetricians and Gynaecologists [84], the NICHD [72], the Society of Obstetrics and Gynecologists Canada [110] and the American College of Obstetricians and Gynecologists [4, 5] as well as evidence-based data, where available. The basis for this guideline is the best available "evidence" which was carefully collected and classified by the members of the consensus group. It was not possible in every case to compile recommendations directly from the evidence level provided in the available literature. The recommendations show what is generally considered good clinical practice, so far as this was not queried by the persons involved in the consensus process. With regard to the requirements speci

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Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing

Cited by 24 publications

References 35 publications

The fetal acoustic stimulation test: a reliable and cost effective method of antepartum fetal monitoring

The fetal acoustic stimulation test: a reliable and cost effective method of antepartum fetal monitoring

Involving the consultant before fetal blood sampling

S1-Guideline on the Use of CTG During Pregnancy and Labor

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