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Ceylon Med J. 2005 Dec;50(4):156-9.

The fetal acoustic stimulation test: a reliable and cost effective method of antepartum fetal monitoring.

Author information

1
University Obstetrics & Gynaecology Unit, Teaching Hospital, Galle, Sri Lanka.

Abstract

RATIONALE:

A healthy foetus, if exposed to external sound stimulation, often responds with vigorous movements which can be felt by the mother. A hypoxic foetus usually does not show this response.

OBJECTIVES:

To evaluate the fetal acoustic stimulation test (FAST) in antepartum fetal monitoring.

DESIGN AND SETTING:

Prospective interventional study carried out at the Teaching Hospital, Galle.

METHOD:

An initial non-stress test (NST) followed by a FAST using the Corometric model 146 was carried out in 423 high risk pregnant women. The response to FAST was assessed and compared with the NST. A repeat NST was recorded in women who had an initial non-reactive NST. The results of the NST and FAST were compared with the fetal outcome if the woman delivered within 24 hours.

OUTCOME MEASURES:

Maternal perception of fetal movements after FAST, results of NST before and after FAST, and the babies' 5 minute Apgar scores if delivered within 24 hours of the FAST.

RESULTS:

Of the women, 349 (82.5%) noticed fetal movements after FAST. Of the 167 women who complained of absent or reduced fetal movements, 67% felt fetal movements after FAST. Ninety one had a nonreactive NST and 43 (47%) became reactive after FAST. Compared to the NST, the FAST had less sensitivity (93% vs 100%, p = 0.01), better specificity (79% vs 45%, p = 0.001), better positive predictive value (67% vs 50%, p = 0.02), similar negative predictive values (96% vs 100%, p > 0.05) and better accuracy (83% vs 69%, p = 0.03) in predicting neonatal asphyxia (5 minute Apgar score < 7) if the baby was delivered within 24 hours after the test.

CONCLUSION:

The FAST is a reliable, cost effective screening test for antepartum fetal monitoring. It significantly reduces the false positive (non-reactive) NST and has a good negative predictive value.

PMID:
16538910
[Indexed for MEDLINE]

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