Nonstress and contraction stress fetal heart rate monitoring. A randomized trial to determine which is the faster primary test

Abstract

Antepartum fetal heart rate monitoring can be performed with either the nonstress or contraction stress method. The recent introduction of nipple stimulation as a means of achieving uterine contraction has simplified performance of contraction stress tests and raises the possibility that that test may be a more rapid approach to antepartum fetal heart rate testing than the nonstress test. In order to investigate the time taken to achieve a satisfactory end point of fetal heart rate monitoring, 186 women were randomized to either "intention to perform nonstress test" or "intention to perform nipple stimulation contraction stress test." Neither approach was found to be significantly faster than the other. One-third of all completed contraction stress tests were classified as equivocal and required further investigation or management. The nipple stimulation contraction stress test was not found to be a more rapid approach to antepartum fetal heart rate monitoring than the nonstress test.