Summary:
Introduction: Non-stress test (NST) is the most common
antenatal test performed to assess the foetus at risk of
intrauterine hypoxia. On the other hand non-reactivity
detected by NST increases the interferences of pregnancy by
Caesarean section.
Methodology: A cross sectional descriptive study was carried
out in the department of Obstetrics and Gynaecology at Dhaka
National Medical College between July2007 and June 2008.
Objectives: The objectives of the study were (1) To observe the
mode of delivery in cases of non-reactive non stress test (NST)
and (2) To evaluate perinatal outcome of non-reactive NST.
Results: A total 137 high risk pregnant women were included
in the study. Age of the women ranges from 16 to 32 years.
The mean age of the women was 23.74 ± 3.71 year. Among
them 44.53% were primaegravida and 55.47% were
multigravida.
Gestational age was between 35 and 42 weeks and mean
gestational age was 38.34±1.42 weeks. Regarding foetal
reactivity 61.3% (n=84) were reactive and 38.7 % (n=53)
were non-reactive. Among the babies of non reactive NST
98.11% and 1.89% were delivered by caesarean section and
vaginal delivery respectively. Whereas, 48.81% and 51.19%
babies of reactive NST were delivered by caesarean section
and vaginal delivery respectively. The percentage of caesarean
section was much higher in non-reactive NST cases in
comparison to that of reactive NST which was statistically
highly significant (p value 0.0000). One minute after birth
APGAR scoring revealed that 56.6% and 43.4% newborn of
non-reactive NST had no depression( APGAR score 7-10)
and mild depression ( APGAR score 4-6) respectively. On the
other hand 65.47% and 34.5% newborn of reactive NST
had no depression and mild depression respectively at one
minute after birth. Therefore, small difference was noticed
in the neonatal status between the reactive and non-reactive
NST which had no statistical significance (p value 0.507).
Evaluation of the neonates with APGAR scoring done 5
minutes after birth revealed mild depression (APGAR score
4-6) in 24.53% and 20.24% of non-reactive and reactive
NST cases respectively and no depression (APGAR score 7-
10) was found in 75.47% and 70.76% in reactive and nonreactive
NST respectively. So, 5 minutes after birth the
neonatal status among reactive and non-reactive NST made
no significant difference (p value 0.9266).
Conclusion: Neonatal evaluation revealed that all foetuses
were not compromised as detected by NST. Relying on NST
the rate of Caesarean section has been increased.
Reassessment of the foetal conditions was needed with the
help of other techniques. Therefore NST alone is
insufficiently predictive of neonatal outcome.
Key word: Non reactive NST, Caesarean section, Neonatal
outcome
(J Banagladesh