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Antepartum heart rate testing in diabetic pregnancy
The Journal of Reproductive Medicine
|July 1, 1985
Summary
Fetal deaths in diabetic pregnancies can occur days after negative antepartum heart rate tests. More frequent testing, including nonstress tests (NST) and contraction stress tests (CST), is recommended for high-risk pregnancies.
Area of Science:
- Perinatal medicine
- Maternal-fetal medicine
- Diabetology
Background:
- Fetal death in utero is a major concern for diabetic pregnancies.
- Antepartum heart rate testing aims to reduce perinatal mortality.
- Current testing protocols may not be sufficient for all diabetic pregnancies.
Purpose of the Study:
- To evaluate the risk of fetal death in diabetic pregnancies after negative antepartum heart rate tests.
- To determine the optimal timing and frequency of fetal surveillance in diabetic pregnancies.
Main Methods:
- Retrospective review of 48 pregnancies (including one set of twins) in women with Class B-F diabetes.
- Analysis of pregnancies with reactive nonstress tests (NST) or negative contraction stress tests (CST) within one week of delivery.
Main Results:
- Four fetal deaths occurred 4-7 days after testing.
- No fetal deaths occurred within 3 days of a negative test.
- This suggests a potential window of vulnerability after testing.
Conclusions:
- Nonstress tests (NST) and contraction stress tests (CST) may not detect all fetal risks in diabetic pregnancies.
- More frequent testing than weekly is advocated.
- Consideration of NST followed by CST for nonreactive NST is recommended.