THE ROLE OF NON-STRESS TEST TO DEC‹S‹ON-MAK‹NG PROCEDURE IN PREGNANT WOMEN W‹TH CESAREAN DEL‹VERY "OUTCOMES OF OUR CL‹N‹C AND LITERATURE REV‹EW"

Abstract

Introduction: Non-stress test (NST) became the basic method to increase fetal survival rates during over 4 decades. Although the accuracy of fetal well-being assesmernt of the method still remains controversial. The basic goal is to predict fetal hipoxia and severe asphyixia and intervene before fetal death happens. On the other hand, prenatal outcome does not improve as desired due to discordance between NST findings and severity of fetal hipoxia. Aim: To determine the power of decision-making role of NST, via retrospective datas of cesarean deliveries indicated with fetal distress according to NST findings. Materials and methods: In Istanbul Medical Faculty Hospital, the datas of 590 cesarean deliveries indicated with fetal distres according to NST findings, between the dates of 2007-2009 were detected retrospectively. Cases were divided into two groups as preterm and term labors. The postpartum term datas selected were; birth weight, APGAR scores of 1st and 5th minutes, cord blood pH, pH, pO2, pCO2, HCO3, base excess (BE). As measuring the value of NST to predict fetal hipoxia, positive predictive value was calculated. As for APGAR scoring; positive and negative predictive values, spesificity, sensitivity were calculated. Result: NST was not found as effective as it was obtained. Only 30% of the cases were found hipoxic. Additionally between those fetuses with hipoxia, 38% had 1st minute APGAR score of 7 (cut-off value) and under. Although in cases with findings of uteroplacental insufficiency NST should give much valuable information, regarding to increase of unnecessary surgical procedures. On the other hand, concept of guideness of NST to operative labor seems to be logical considering medicolegal issues.