Role of Nonstress test in improving the perinatal outcome in pregnancies complicated by preeclampsia

Abstract

Introduction: Antepartum fetal surveillance is the assessment of fetal well being in utero before the onset of labour. It helps in early detection of fetuses at risk, so that timely management can prevent further deterioration, thereby reducing perinatal morbidity / mortality. Around 10-30% of the mothers seen in antenatal period can be classified as high risk but they account for 70-80% of perinatal mortality / morbidity. Aim And Objectives: The role of NST in management of pregnancies complicated by preeclampsia and comparison of maternal and perinatal outcome in patients of preeclampsia undergoing NST and without NST. Material and Methods: Present study was carried out in 100 patients of preeclampsia with singleton pregnancy, cephalic presentation of more than 32 weeks period of gestation. Group I (cases) -100 patients of preeclampsia in whom NST was done. Group II (controls)retrospective analysis of medical records of 100 patients of preeclampsia in the past 1 year where NST was not done. Results: The mean age of women in group I was 24.63±3.63 years and 24.53±3.74 in group II. 4. Maximum number of women i.e. 59% in group I and 55% in group II were primi para (p >0.05). Majority of women were admitted at 37-38 weeks period of gestation i.e. 40% in group I and 38% in group II (p >0.05). Out of 100 women in group I who were subjected to nonstress tests, a total of 68(68%) women were found to have reactive NST while 32(32%) women had non-reactive NST. Thirty two non-reactive NST cases were further subjected to BPS out of which 26(81.25%) were normal and 6(18.75%) were associated with abnormal BPP. Twenty six patients who had normal BPP, were followed up with weekly BPP. Out of 68 NST reactive cases, fourty six (67.64%) women delivered vaginally and 22(32.35%) underwent cesarean section and in non-reactive 32 cases, nine (28.12%) women delivered vaginally and 23(71.87%) women underwent cesarean section which is statistically significant (p<0.05). Sixty (88.23%) newborns in reactive NST group had normal birth weight and 19(59.37%) newborns in non-reactive NST group had normal birth weight which is statistically significant (p<0.05). Apgar score >7/10 at 1 & 5 minutes was found in 64(94.11%) newborns in reactive NST group and 22(73.33%) newborns in nonreactive NST group which is statistically significant (p<0.05). Nine (13.23%) newborns were admitted in reactive NST group and 17(56.66%) in non-reactive NST group. Conclusion:The major goal of antepartum fetal surveillance is an appropriate & timely identification of fetuses at risk of morbidity and mortality & thus unnecessary delay in interventions can be avoided and hence a better perinatal outcome could be achieved. An equally important goal is to avoid unnecessary intervention in an uncompromised fetus.

Comparative Assessment of the Umbilical Artery Doppler Velocimetry and Non-Stress Test in Evaluating the Fetal Well-Being among Women with Pre-Eclampsia

“…(p <0.001). Similar results were seen in a study conducted by Jamatia A et al 33 Bagum et al 81 observed that reactive NST group showed favourable fetal outcome and non-reactive NST showed significant increase in overall abnormal outcome, low 1 & 5 minute Apgar score, more NICU admissions and more perinatal mortality rates. 34 They concluded that NST is a valuable tool for the assessment of fetal wellbeing in high risk pregnancies.…”

Evaluation of non-stress test as predictor of perinatal outcome in high risk and low risk pregnancy: a prospective study

“…It facilitates early detection of fetuses at risk, so timely management can prevent further damage and thus reduce perinatal morbidity/mortality. 4 NST is considered as a good predictor of fetal health and is recommended after 32 weeks of pregnancy. Prenatal Non stress test is also a component of Biophysical profile.…”