Antepartum fetal heart rate testing. IV. The nonstress test as a primary approach.

During a 1 year period from July 1, 1977, to June 30, 1978, 1,877 NST's were performed in 895 patients. Criterion for a reactive test was two accelerations associated with fetal movement in one of two 20 minute periods. Fetuses with nonreactive patterns were stimulated by abdominal wall manipulation. A total of 1,644 tests demonstrated reactive patterns and 229 tests were NR; 146 NR's were followed by CST's. During 75 CST's, the pattern became reactive and the test was terminated. Seventeen of 71 completed CST's were abnormal (24%). There were 634 patients delivered within 1 week of an NST-CST. Seventeen of 62 patients with NR tests underwent cesarean section for fetal distress as compared to 11 of 572 patients with reactive patterns.