Evaluation of nonstress fetal heart rate testing in multiple gestations.

Routine serial nonstress fetal heart rate testing was evaluated in 94 patients with multiple gestations (193 fetuses). Reactive testing was associated with an uncomplicated perinatal outcome in 89% of the cases. Nonreactive fetuses had a significantly higher incidence of perinatal morbidity, including fetal distress in labor (77.8%), asphyxia (48%), and intrauterine growth retardation (28%). Overall perinatal mortality (21/1000) was nearly comparable to that observed in singleton pregnancies. Nonreactive fetuses had a perinatal death rate that was more than six times that of the reactive ones (80/1000 versus 12/1000). Antepartum nonstress testing was found to be a highly reliable and predictive tool in the assessment of multiple gestations.