The nonstress test: an evaluation of 1,000 patients

In November, 1978, the fetal heart rate nonstress test (NST) was instituted as the primary screening procedure for the evaluation of fetal well-being at Vanderbilt University Hospital. The results of the first 1,000 patients tested are presented. The stillborn rate within 8 days of a reactive NST was 6.4 per 1,000, with the stillbiths occurring either in patients with diabetes mellitus or with intrauterine growth retardation (IUGR). A review of other series in which both the total indications for nonstressed testing and the risk groups in which stillbirths occurred within 7 days of an NST reveals that patients with diabetes mellitus (p less than 0.025) and patients with IUGR (p less than 0.01) are at greater risk for stillbirth within 7 days of an NST. Weekly nonstress testing, effective in preventing stillbirths in most risk groups, is not adequate in patients with diabetes mellitus or IUGR.