Tests during pregnancy - Contraction-stress-test- Pregnancy forum

Contraction Stress Test
During labor, the baby will experience low oxygen levels with each contraction. A contraction stress test evaluates the ability of your developing baby to tolerate the low levels of oxygen. The test is done either in your obstetrician's office or at the hospital. It does not usually require an overnight stay. You will be asked to undress and put on a hospital gown. For your own comfort, you may want to empty your bladder before the test.

For the duration of the test, you will lie in a semireclining position and be tilted slightly to your left side to avoid pressure on your abdominal blood vessels. Maintaining this position may be uncomfortable or painful when you are having labor contractions. Two belts with sensors attached will be placed around your abdomen. One belt holds the sensor that detects your baby's heart rate; the other measures the timing and duration of your uterine contractions. Gel may be used to provide good contact between the heart rate sensors and your skin. The sensors are attached with wires to a recording device that can indicate or print out a record of your baby's heart rate as well as the strength and duration of your uterine contractions. The heart rate monitor may be moved if your baby changes position.

The external fetal monitor will record your baby's heart rate and contractions of the uterus for 10 minutes. Your blood pressure and other vital signs are also taken during this preliminary test period. If spontaneous contractions don't occur during this 10-minute period, you will be given an intravenous infusion of oxytocin, and then your contractions will be recorded on the monitor. The infusion begins with a low dose that is gradually increased, if needed, until you have three contractions within 10 minutes, each one lasting longer than 45 seconds.

Nipple stimulation may be used instead of an oxytocin. Nipple stimulation prompts your body to produce oxytocin naturally. You will be asked to massage your nipple by hand until contractions start. If you don't have a second contraction within 2 minutes of the first, you will massage your nipple again. If contractions don't occur within 15 minutes, you will stimulate both nipples. This procedure may be repeated for up to a maximum of 10 minutes on one breast. Because nipple stimulation can cause long, uncontrolled contractions, an oxytocin infusion is preferred by some health professionals. Normal results will show that your baby's heart rate does not decrease and stay low beyond the contaction. If three contractions occur within the 10-minute time frame and there are no decreases in your baby's heart rate, your baby is expected to be able to tolerate the stress of labor. If the results of the stress test show that the placenta is nto capable of handling the pregnancy, immediate delivery is suggested.

After the test, you will be monitored until your contractions return to the pretest level. A contraction stress test may last up to 2 hours.

Continuous electronic fetal heart monitoring does have the risk of indicating fetal distress when your baby is actually healthy. This can cause an unnecessary cesarean delivery, especially in low-risk pregnancies. On rare occasions, generally as the result of technical problems, the monitor may indicate that your baby is normal when it is actually in distress. There are no other risks from external monitoring. Fetal heart monitoring cannot predict every type of fetal problem, such as birth defects. By receiving oxytocin, it is possible for labor to begin. This would be risky if you are not near your due date. Oxytocin can also cause prolonged contractions that may cause fetal distress.

There are factors that can interfere with your test and the accuracu of the results. This includes, a cesaren section with a vertical incision, placenta previa, placenta abruption, a pregnancy with twins or more, an incompetent cervix, smoking, using cocaine, your position, obesity, motion during the test, having a full bladder and noises.

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