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Terminal pattern: characteristics and management.

O Langer, M Vega-Rich, W Cohen

    American Journal of Perinatology
    |October 1, 1985
    PubMed
    Summary
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    Certain terminal prepartum non-stress test (NST) patterns indicate a high risk of perinatal mortality and asphyxia. These ominous NST findings, especially with absent fetal movement or oligohydramnios, warrant immediate cesarean delivery.

    Area of Science:

    • Perinatology
    • Maternal-Fetal Medicine
    • Neonatal Outcomes

    Background:

    • Terminal prepartum fetal heart rate patterns can indicate significant fetal distress.
    • Specific non-stress test (NST) findings are associated with adverse perinatal outcomes.
    • Conditions like intrauterine growth retardation, preeclampsia, and prolonged pregnancy are risk factors.

    Purpose of the Study:

    • To analyze terminal prepartum non-stress test (NST) patterns.
    • To correlate these patterns with perinatal mortality and asphyxia rates.
    • To identify high-risk NST findings and associated maternal/fetal conditions.

    Main Methods:

    • Retrospective analysis of terminal prepartum NST patterns from 31 patients.
    • Correlation of NST findings with perinatal mortality and asphyxia.

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  • Identification of associated conditions such as intrauterine growth retardation, preeclampsia, and prolonged pregnancy.

    • Main Results:

    • Terminal prepartum patterns were linked to a 39% perinatal mortality rate.
    • Survivors experienced significant perinatal asphyxia.
    • Ominous NST patterns (absent accelerations, reduced variability, late decelerations) combined with absent fetal movements and/or oligohydramnios predicted a 39% perinatal mortality.

    Conclusions:

    • Specific terminal prepartum NST patterns are highly predictive of poor perinatal outcomes.
    • The presence of absent fetal movements and/or oligohydramnios exacerbates the risk associated with ominous NST findings.
    • Immediate cesarean section is recommended when these high-risk conditions are identified.