Fetal Testing

Biophysical Profile

• Path: No contractions, APGAR
• Pt: Failed NST, vibroacoustic stimulation (VAS)
• Dx:
  • NST (0-2)
    
  • Amniotic fluid index (0-2)
    
  • Breathing (0-2)
    
  • Movement (0-2)
    
  • Tone (0-2)
    
• Tx:
  • 8-10 => Reassurance
    
  • 2-8 => depends on GA
  • 0-2 => C-section

Amniotic fluid index

• Sum of all 4 quadrants together:
  
  • Normal >5
    
  • Reassuring = 8-25
    
  • Oligo <5
    
  • Poly >25

Contraction Stress Test

• Path: + contractions, decals, brady, 3 contractions over 10mins (200mV)
  
• Pt: Labor, failed BPP

Variable decelerations

• decelerations that do not follow contractions
  
• Caused by cord compression

Early decelerations

• baby’s HR drops at the same time there is a contraction
  
• Caused by Head compression

Late decelerations

• baby’s HR drops after there is a contraction.
  
• Caused by utero placental insufficiency