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[Non-reactive pattern diagnosed by ultrasonic Doppler fetal actocardiogram and outcome of the fetuses with
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tottori University, Yonago.
The accuracy of diagnosis by means of ultrasonic Doppler fetal actocardiogram in non-stress test (NST) was examined in 100 fetuses at 32 to 42 weeks of gestation. Fourteen fetuses were diagnosed as non-reactive by conventional NST which monitored fetal heart rate, but only 4 of the 14 fetuses were found to be "non-reactive" when the fetal actocardiogram was used. Thus the false positive rate obtained with conventional NST in judging the non-reactive pattern was 71.4% (10/14). We next examined the outcome for 25 fetuses (including 20 IUGR cases) with a "non-reactive pattern" who were diagnosed by fetal actocardiogram. Fetal distress occurred in 19 of these fetuses (76.0%), and mostly developed within 5 days after the diagnosis of "non-reactive pattern". The outcome for 20 IUGR fetuses with a "non-reactive pattern" was compared with that for fetuses with a "reactive pattern". IUGR fetuses which were "non-reactive" had a significantly higher fetal distress morbidity rate, and higher cesarean section rate. The sensitivity and specificity of the prediction of the development of fetal distress in IUGR fetuses with a "non-reactive pattern" were 81.0% and 84.2%, respectively. The present results strongly suggest the need to use the ultrasonic Doppler fetal actocardiogram at the time of NST after 32 weeks of gestation.
The accuracy of diagnosis by means of ultrasonic Doppler fetal actocardiogram in non-stress test (NST) was examined in 100 fetuses at 32 to 42 weeks of gestation. Fourteen fetuses were diagnosed as non-reactive by conventional NST which monitored fetal heart rate, but only 4 of the 14 fetuses were found to be "non-reactive" when the fetal actocardiogram was used. Thus the false positive rate obtained with conventional NST in judging the non-reactive pattern was 71.4% (10/14). We next examined the outcome for 25 fetuses (including 20 IUGR cases) with a "non-reactive pattern" who were diagnosed by fetal actocardiogram. Fetal distress occurred in 19 of these fetuses (76.0%), and mostly developed within 5 days after the diagnosis of "non-reactive pattern". The outcome for 20 IUGR fetuses with a "non-reactive pattern" was compared with that for fetuses with a "reactive pattern". IUGR fetuses which were "non-reactive" had a significantly higher fetal distress morbidity rate, and higher cesarean section rate. The sensitivity and specificity of the prediction of the development of fetal distress in IUGR fetuses with a "non-reactive pattern" were 81.0% and 84.2%, respectively. The present results strongly suggest the need to use the ultrasonic Doppler fetal actocardiogram at the time of NST after 32 weeks of gestation.