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

Abstract

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.

Investigating the significance and current state of knowledge and practice of absent or reduced fetal movements in low and lower middle-income countries: a scoping review

“…Twelve studies reported data on women's knowledge of fetal movements 18 -19 and seven included quantitative data. 20 -21 One author was contacted for information 21 ; however additional relevant data were not available.…”

Quality of reporting clinical trials published in five leading Sri Lankan medical journals

“…We retrieved 39 trials for assessment of the quality of reporting, of which 32 (82%) were from the Ceylon Medical Journal. Of 39 trials, 15 (38.5%) were randomized clinical trials and 24 (61.5%) were non‐randomized trials (Table ). All RCTs were parallel group and phase III trials and 11 (73%) published after CONSORT was introduced in 1996.…”

“…Of 39 trials, 38 (97.4%) had abstracts. Eleven (28%) reported the study design in the title and 23 (59%) in the abstract and 10 (25.6%) in the methods. The accepted terminology for the study designs were reported only in 12 (30.7%) trials and 4 (10%) were reported as either prospective studies or descriptive studies in the main manuscripts, and 13 (36%) had not mentioned the study design anywhere of the article, of which 4 (30.7%) were RCTs.…”

“…The success of blinding was not evaluated in all blinded trials. Ethical clearance was granted by an Ethics Review Committee was reported by 14 (36%) of all trials and 7 (47%) of RCTs. It is reported that the consent was obtained by 16 (41%) studies.…”

Fetal acoustic stimulation test for early intrapartum fetal monitoring

“…The authors of a recent Cochrane Systematic Review have recommended further research in to vibro acoustic stimulation for fetal assessment during labour [17]. In a previous study we showed that the FAST was a reliable and cost effective method of screening for antenatal fetal wellbeing, which could be used to complement the NST [18]. The objective of the current study was to evaluate the FAST as a screening method for assessing fetal well being in the early intrapartum period.…”