Tests for Monitoring Your Baby's Health

 

Special tests may be used to check the well-being of your unborn baby during pregnancy. These tests can help reassure you and your health care provider that all is going well. If problems arise, tests can help alert your health care provider that you or your baby may need special care.

 

          Fetal Kick Counts

 

Fetal movement counting (also called “kick counts”) is a test that you can do at home. Your health care provider will tell you how often to do it and when to notify him or her.

 

Why Do I need to do Kick counts?

If you have felt your baby moving less often, your health care provider may ask you to keep track of your baby's movements. Maintaining the same level of movement is a sign that the baby is doing well.

 

How Are Kick Counts performed?

One way to do kick counts is to lie on your side and note how long it takes the baby to make 10 movements. If it takes fewer than 2 hours, the result is “reassuring” (which means that for now, it does not appear that there are problems). Once you have felt 10 movements, you can stop counting that day. This test is repeated daily. Another way to do kick counts is to note fetal movements for 1 hour three times a day. You should feel at least as many movements as you usually have felt before.

 

What Do the Results Mean?

If you do not feel enough movement, your health care provider may do other tests to check the baby. These tests include the nonstress test, biophysical profile, modified biophysical profile, or contraction stress test.

 

           Nonstress Test (NST)

 

The nonstress test is the most common special fetal test. It measures the baby's heart rate in response to the baby's own movements.

 

Why Do I Need to do a NST?

This test is done to assess the health of the baby. Usually the baby's heart beats faster when he or she moves. Such changes in the fetal heart rate are believed to be a sign of good health.

 

How Are NSTs performed?

This test may be done in the health care provider's office or in a hospital. The test is done while you are reclining or lying down and usually takes at least 20 minutes. For this test, two belts are placed across your abdomen: one belt has sensors that measure the fetal heart rate and the other belt has sensors to detect uterine contractions. You are asked to note when the baby moves by pressing a button, which indicates on the fetal heart rate record when a movement has occurred. Most babies have a sleep-wake cycle of 20–40 minutes. Sometimes, the baby may be asleep and will not move two times in 20 minutes. If this happens, the test may last 40 more minutes, or the baby may be stimulated to move with sound projected over the mother's abdomen.

 

What Do the Results Mean?

 

Results of the nonstress test are classified as reactive (reassuring) or nonreactive (nonreassuring). A nonreactive result does not necessarily mean that the baby is not healthy. Nonreactive results may occur because the baby was asleep during the test. Another reason for a nonreactive nonstress test result is that the baby may be too young at the time the test is given. Nonreassuring nonstress test results are often followed by a biophysical profile or contraction stress test to give more information.

 

         Biophysical Profile (BPP)

 

A biophysical profile (BPP) test measures the health of your baby (fetus) during pregnancy. A biophysical profile uses ultrasound to check on a baby's well-being. A BPP test may include a nonstress test with electronic fetal heart monitoring and a fetal ultrasound. The BPP also may be done when results of other tests are nonreassuring.

 

Why Do I Need a BPP?

A BPP helps assess fetal well-being in these five areas:

• Fetal heart rate

• Fetal breathing movements

• Fetal body movements

• Fetal muscle tone

• Amount of amniotic fluid around your baby

 

These are evaluated and given a score.

 

 How Is a BPP performed?

 

A BPP involves monitoring the fetal heart rate (the same way it is done in a nonstress test) as well as an ultrasound exam. Each of the five areas is given a score of 0 or 2 points, for a possible total of 10 points.

 

What Do the Results Mean?

A low score on a biophysical profile might indicate that you and your baby need further monitoring or special care. In some cases, early or immediate delivery might be recommended. A high score on a biophysical profile is reassuring and continued surveillance of your pregnancy is recommended.