Has your Gynecologist advised to get a NST done? Let us know what is NST, why it is required more often in high risk pregnancy and how it is taken?

A Non-Stress Test (NST) is a common prenatal test used to assess the well-being of a baby during pregnancy, especially in the third trimester. The test is simple and painless, involving the monitoring of the baby’s heart rate in response to movements.

Here’s a detailed explanation of why NST is recommended, how it's done, and what the guidelines say:

Why Do Gynecologists Advise NST? 

Monitoring Fetal Health: 

NST helps ensure that the baby is getting enough oxygen and is not under stress. 

A healthy baby will typically have an increase in heart rate when it moves. This increase is what gynecologists look for during the test to confirm that the baby is thriving.

Assessing High-Risk Pregnancies: 

NST is often recommended more frequently in high-risk pregnancies where there are concerns about the baby’s health. Conditions like gestational diabetes, high blood pressure, decreased fetal movements, or a previous history of pregnancy complications can prompt doctors to monitor the baby more closely.

Tracking Fetal Movements:

In some pregnancies, the mother may notice a reduction in the baby’s movements. NST is a way to quickly assess the baby's well-being in such cases. If the baby’s heart rate doesn't increase as expected during movements, it could indicate that the baby is under stress or that further testing is needed.

Late-Term Monitoring:

NST is frequently advised after 32-34 weeks of pregnancy in routine prenatal care. It’s especially common if a woman goes past her due date or if there are concerns about the baby’s size or placental function as the pregnancy progresses.

Why Is NST Advised More Often in Pregnancy?

NST is used more often in pregnancies where there are concerns about fetal distress or compromised health due to:High-risk factors such as hypertension, diabetes, or multiple pregnancies.

Decreased fetal movements, which may be a sign that the baby isn’t getting enough oxygen.

Post-term pregnancies, where the risk of placental insufficiency rises after the due date.

Monitoring for fetal hypoxia, where the baby may not be getting enough oxygen from the placenta.

Previous pregnancy complications, such as stillbirth or preterm birth, to ensure that current pregnancies progress without complications.

ACOG Guidelines for Non-Stress Tests (NST)

According to ACOG (American College of Obstetricians and Gynecologists), NST is a standard test in evaluating fetal well-being in high-risk pregnancies. ACOG guidelines recommend NST in the following situations: After 32 weeks of gestation for high-risk pregnancies. Earlier, around 26-28 weeks, if there are significant concerns (such as preeclampsia, intrauterine growth restriction (IUGR), or other complications).For women with conditions such as gestational diabetes, hypertension, or decreased fetal movements. In cases where there is concern for fetal hypoxia or placental insufficiency, regular NSTs help assess the baby's oxygen levels and general health. 

ACOG also suggests that NST be performed twice a week in some high-risk pregnancies to closely monitor the baby's status.

Medical Equipment Used for NST

The primary equipment used during an NST includes:

Fetal Doppler Monitor (Electronic Fetal Monitor)This device has two sensors that are attached to the mother’s abdomen using elastic belts.

One sensor measures the baby’s heart rate using ultrasound waves (fetal heart rate monitor).

The second sensor detects any uterine contractions or fetal movements.

CTG Machine (Cardiotocograph): The cardiotocograph (CTG) machine is connected to the sensors to record and display the baby’s heart rate and movements on a graph. 

The output is displayed in real-time and also recorded for later analysis.

Monitoring Software:

Some modern equipment includes software that analyzes the heart rate patterns and provides insights into the baby's well-being based on the data.

How the NST Works

During the NST: The mother is asked to lie down or sit comfortably. Two belts with sensors are placed around the abdomen. As the baby moves, the heart rate is monitored, and the doctor looks for accelerations in the heart rate in response to movement, which is a sign that the baby is doing well.

The test usually lasts between 20-40 minutes, depending on the baby’s level of activity. If the baby is not very active during the test, the doctor might try to stimulate movements by giving the mother a sugary drink or lightly tapping the abdomen.

Conclusion

The Non-Stress Test (NST) is a valuable tool for ensuring that your baby is thriving, particularly in high-risk pregnancies. By using advanced monitoring technology, doctors can detect any potential issues early and take the necessary steps to protect the health of both mother and baby. Regular NSTs, as recommended by ACOG, allow for proactive management, ensuring that even in high-risk scenarios, the baby can be closely monitored and cared for.

Dr Uma Mishra

MD, Obstetrics & Gynecology

Leading Gynecologist in Noida, High Risk Pregnancy Care Expert, Normal Baby Delivery

Website: https://www.drumamishra.com 

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