High-Risk Pregnancy

What are they looking for during a nst?

With my first pregnancy we didn't do NST's.  Just once when I was sent to L&D because I failed my BPP.  But we did weekly BPPs.  Now I'm doing twice weekly NSTs and weekly BPPs, plus weekly visits with my OB and weekly visits with the MFM.  AGH.  That's a scheduling nightmare. 

 Anyway, I have chronic hypertension, severe asthma and also GD.  The GD is almost directly correlated to my steroid dosage.  Anyway...

My last two NST's haven't gone so well.  They've kept me on the monitor for excess of an hour both times.  The first time they did this, I had just had lunch.  I felt like the baby was moving well, but apparently not.  And usually his heartbeat hung out in the 150s.  The second one same thing - but no lunch yet.  So they gave me orange juice.  That didn't produce the reaction they were looking for so after an hour they sent me downstairs to eat and come back for another test.

 I know they are looking for accelerations and decelerations in relation to his movement.  But what else.  His heartrate seems somewhat reactive, but not hugely so. 

I would have asked my doc on the last test but he got called to do an emergency c-section.  I see him again tomorrow and the two incidents combined have me worried. 

Re: What are they looking for during a nst?

  • So I will use the numbers you said as an example to try to make this make sense for you.

    First, they establish a baseline heart rate--the one that baby is when resting...we'll call that 150 bpm for you. So, within 20 minutes they need to see that baby's heart rate accelerates at least 15 bpm and the acceleration from start to end needs to last at least 15 second, and this needs to happen 3 times (at least for my OB). Usually this correlates with movement. Another kicker, is that sometimes, if the baby moves off of the monitor for a few seconds--that leaves a big ?? and they may restart your time--some feel comfortable assuming there wasnt a big decel in that time and some just dont. They also look for a correlation between contractions (if any are seen) and decelerations in the baby's heart rate.

    Good luck. Hopefully you wont have to stay on so long next time. I know sometimes some NSTs are longer than others for me too.

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  • I'm having the SAME problem and it's stressful. Baby is not accelerating like he should on periodic NST's so we have done more along with BPP's. The BPP U/S look great just not the heart rate pattern they look for. 

    I'm also having decreased fetal movement. Are you also experiencing that? If LO doesn't get moving in an hour or so I'm headed BACK to L&D. I am getting very frustrated but can't ignore the decreased movement.  

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