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Assessment of fetal well-being using the nonstress test in the home setting
R W Naef1, J C Morrison, J F Washburne
1Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi.
Objective:
To determine the feasibility of performing nonstress tests (NSTs) in the home setting instead of the health clinic environment.
Methods:
In this prospective study, ten women were tested using a Sonicaid TEAM portable monitor and a Hewlett-Packard device in the health clinic. The women were then instructed on use of the Sonicaid device and were tested once a week in the home as well as in the high-risk clinic. All tests were reviewed independently by two of the authors to assess agreement in interpreting the NST. In the health clinic setting, a nonreactive NST was followed by a nipple stimulation contraction stress test (CST); in the home, a nonreactive NST was followed by maternal voice acoustic stimulation.
Results:
There was 100% correlation during the concurrent study. Two blinded authors agreed on all tests. During the second phase, eight of the ten subjects had NSTs that were consistently reactive in both the home and office settings. In one woman, a nonreactive NST in the clinic was followed by a negative CST. In the remaining patient, a reactive NST in the health clinic was followed 3 days later by a nonreactive NST in the home, which persisted in the provider's office.
Conclusion:
Nonstress testing in the home appears to be an accurate method of antenatal fetal health assessment that adds convenience and potential cost savings.