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Fetal acoustic stimulation for rapid intrapartum assessment of fetal well-being
Y Tannirandorn1, T Wacharaprechanont, S Phaosavasdi
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Fetal heart rate reactions to the fetal acoustic stimulation test (FAST) were prospectively studied in 140 women in early labor. Overall 45 of 140 patients (32%) had one or more complications of pregnancy. All were in the latent phase of labor with a singleton, vertex-presenting fetus. Gestational age ranged from 37-43 wks. The women were screened with a 15-20 min fetal heart rate recording (FHR admission test) before the acoustic stimulation was applied. Results of the FHR admission test and the FAST in women were compared with fetal outcome; which was considered poor when there was perinatal death, a 5 min Apgar score less than 7, fetal distress requiring cesarean section, thick meconium stained amniotic fluid or admission to the neonatal intensive care unit. FAST had better sensitivity (71.4% vs 42.8%), specificity (99.2% vs 97.7%), positive predictive value (83.3% vs 50.0%) and negative predictive value (98.5% vs 97.0%) for poor fetal outcome than the FHR admission test. Fetal acoustic stimulation test in the early intrapartum period may be used as a noninvasive screening method for rapid intrapartum assessment of fetal wellbeing. It may discriminate the compromised from the noncompromised fetus. This clinical application can be helpful in a busy labor room when rapid assessment of fetal health is required.
Fetal heart rate reactions to the fetal acoustic stimulation test (FAST) were prospectively studied in 140 women in early labor. Overall 45 of 140 patients (32%) had one or more complications of pregnancy. All were in the latent phase of labor with a singleton, vertex-presenting fetus. Gestational age ranged from 37-43 wks. The women were screened with a 15-20 min fetal heart rate recording (FHR admission test) before the acoustic stimulation was applied. Results of the FHR admission test and the FAST in women were compared with fetal outcome; which was considered poor when there was perinatal death, a 5 min Apgar score less than 7, fetal distress requiring cesarean section, thick meconium stained amniotic fluid or admission to the neonatal intensive care unit. FAST had better sensitivity (71.4% vs 42.8%), specificity (99.2% vs 97.7%), positive predictive value (83.3% vs 50.0%) and negative predictive value (98.5% vs 97.0%) for poor fetal outcome than the FHR admission test. Fetal acoustic stimulation test in the early intrapartum period may be used as a noninvasive screening method for rapid intrapartum assessment of fetal wellbeing. It may discriminate the compromised from the noncompromised fetus. This clinical application can be helpful in a busy labor room when rapid assessment of fetal health is required.