II. Cost: $250

III. Technique

  1. Oxytocin (Pitocin)
    1. Start: 0.5 to 1.0 mU per minute
    2. Titrate: increase 1 mU every 20 minutes
    3. Goal: 3 Contractions every 10 minutes
  2. Nipple Stimulation

IV. Contraindications

  1. Absolute
    1. Placenta Previa
    2. Preterm Prolonged Rupture of Membranes (PPROM)
    3. Cerclage
    4. Incompetent Cervix
  2. Relative
    1. Multiple Gestation
    2. History of classic Cesarean Section

V. Interpretation

  1. Negative (Normal)
    1. Adequate contractions:
      1. Three contractions in 10 minutes
      2. Each contraction lasts 40 seconds
    2. No Late Decelerations
  2. Positive
    1. Repetitive, persistent Late Decelerations
    2. Decelerations with more than half of contractions
    3. Not due to uterine hyperstimulation

VI. Management

  1. Negative Contraction Stress Test
    1. Reassuring for fetal well being for 7 days
    2. Follow daily Fetal Kick Counts
  2. Positive Contraction Stress Test
    1. Hasten fetal delivery

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Ontology: Contraction stress test (C0200068)

Definition (NCI) A test done to check for the fetal well being after administering oxytocin or nipple stimulus to induce uterine contractions in the mother. An external fetal heart rate monitor is used to assess the fetal heart rate in response to the uterine contractions.
Concepts Diagnostic Procedure (T060)
SnomedCT 60473002, 391899004
English CST - Contraction stress test, pregnancy contraction stress test (lab test), pregnancy contraction stress test, contraction stress test, contractions stress test, contraction stress testing, Uterine Contraction Stress Test, Contraction Stress Test, Contraction stress test, Contraction stress test (regime/therapy), Contraction stress test (procedure)
Spanish prueba de esfuerzo de contracción (procedimiento), prueba de esfuerzo de contracción (régimen/tratamiento), prueba de esfuerzo de contracción