Clinical utility of the nonstress test in the conservative management of women with preterm spontaneous premature rupture of the membranes

C. V. Smith, J. Greenspoon, J. P. Phelan, L. D. Platt

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12 Citations (Scopus)

Abstract

Preterm spontaneous premature rupture of the membranes (SPROM) is responsible for significant perinatal morbidity and mortality, largely related to prematurity. Consequently, conservative management is frequently elected. These pregnancies, however, are still at risk. Antepartum fetal heart rate testing has been of demonstrable value in other high-risk pregnancies and should offer a method of assessing risk in SPROM. Therefore, a retrospective analysis of patients with SPROM who underwent antepartum fetal heart rate testing was undertaken to evaluate its clinical utility in identifying the fetus at risk. Forty-eight patients underwent 154 nonstress tests in the study population. Indications for delivery included fetal pulmonary maturity, amnionitis and persistent variable decelerations with the failure of amniotic fluid to reaccumulate. Variable decelerations were present in 32% of all tests. Fetal heart rate abnormalities severe enough to warrant delivery were noted in 10 of 48 patients (21%). No intrauterine deaths occurred. Our data suggest that once conservative management is elected in preterm patients with SPROM, the nonstress test may identify fetuses at risk of repeated umbilical cord compression and may allow continuous monitoring or delivery.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume32
Issue number1
StatePublished - Jan 1 1987

Fingerprint

Spontaneous Rupture
Fetal Heart Rate
Deceleration
Membranes
Fetus
Chorioamnionitis
High-Risk Pregnancy
Congenital Heart Defects
Umbilical Cord
Perinatal Mortality
Amniotic Fluid
Morbidity
Pregnancy
Lung
Conservative Treatment
Preterm Premature Rupture of the Membranes
Population

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

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abstract = "Preterm spontaneous premature rupture of the membranes (SPROM) is responsible for significant perinatal morbidity and mortality, largely related to prematurity. Consequently, conservative management is frequently elected. These pregnancies, however, are still at risk. Antepartum fetal heart rate testing has been of demonstrable value in other high-risk pregnancies and should offer a method of assessing risk in SPROM. Therefore, a retrospective analysis of patients with SPROM who underwent antepartum fetal heart rate testing was undertaken to evaluate its clinical utility in identifying the fetus at risk. Forty-eight patients underwent 154 nonstress tests in the study population. Indications for delivery included fetal pulmonary maturity, amnionitis and persistent variable decelerations with the failure of amniotic fluid to reaccumulate. Variable decelerations were present in 32{\%} of all tests. Fetal heart rate abnormalities severe enough to warrant delivery were noted in 10 of 48 patients (21{\%}). No intrauterine deaths occurred. Our data suggest that once conservative management is elected in preterm patients with SPROM, the nonstress test may identify fetuses at risk of repeated umbilical cord compression and may allow continuous monitoring or delivery.",
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