Evaluation of the Nonreactive Positive Contraction Stress Test Prior to 32 Weeks: The Role of the Biophysical Profile

Patrick A. Merrill; Manuel Porto; Stuart M. Lovett; Wendy Dorchester; Michael P. Nageotte; Thomas J. Garite; Roger K. Freeman

doi:10.1055/s-2007-994459

American Journal of Perinatology, Table of Contents

Am J Perinatol 1995; 12(4): 229-231
DOI: 10.1055/s-2007-994459

ORIGINAL ARTICLE

Evaluation of the Nonreactive Positive Contraction Stress Test Prior to 32 Weeks: The Role of the Biophysical Profile

Patrick A. Merrill, Manuel Porto, Stuart M. Lovett, Wendy Dorchester, Michael P. Nageotte, Thomas J. Garite, Roger K. Freeman

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California at Irvine, and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Long Beach Memorial Women's Hospital, University of California at Irvine Medical Center, Orange, California

Abstract

ABSTRACT

A nonreactive positive contraction stress test in a pregnancy near term is an indication for delivery. Such nonreassuring antepartum testing combined with severe prematurity presents a management dilemma. Ideally, prolongation of selected pregnancies would allow time for corticosteroid therapy and fetal maturation. Prior to 32 weeks' gestation, we utilized the biophysical profile to select patients for continued intrauterine management as an alternative to immediate delivery. Continued surveillance was undertaken if the fetus had a reassuring biophysical profile score; immediate delivery by cesarean section was undertaken if the biophysical profile score was nonreassuring. This approach allowed a mean gain of 13 days in utero for the continued surveillance group. There was no evidence of further fetal compromise in this group based on umbilical cord pH or 5-minute Apgar scores. These data suggest that the biophysical profile can be safely used to prolong selected preterm pregnancies with nonreactive positive contraction stress tests without adversely affecting the initial neonatal metabolic status.

Keywords

Contraction - stress test - biophysical profile - pregnancy - prematurity - heart rate monitoring

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