Contraction Stress Test: The Underline Physiological and Technological Basis For The CST Are As Follows

CONTRACTION STRESS TEST
Contraction stress test assesses and functioning and the foetus projected ability to cope with
the continuation of high-risk pregnancy and the stress of labour.
It's the physician in selecting the optimal time for delivery of high-risk foetus.
The underline physiological and technological basis for the CST are as
follows:
 Contraction decreases the blood flow throughout the intravillus space.

 If the uteroplacental versus is normal this intermittent increases in blood flow by
contraction will not negatively affect the foetus.
 If the uteroplacental was is diminished or suboptimal the intermittent decreased in
blood flow by contraction will affect the foetus.
 This negative effect on the foetus is reflected as a fetal heart pattern of late
deceleration.
 This is a test that ascertain the foetus response to contraction naturally occurring, or
induced by nipple stimulation or oxytocin by heart rate and the uterine contractions.
INDICATIONS FOR CST
 Post maturity (suspected or actual)

 Intrauterine growth retardation and respected by a small for gestational age (SGA)
foetus.
 History of previous stillbirth.
 Meuconium stained amniotic fluid obtained at amniocentesis.
 Falling or abnormal estrol values
 Diabetes
 Toxemia or hypertensive disorders of pregnancy.
 Chronic hypertension
 Chronic heart diseases
 Hyperthyroidism
 Collagen disease
 Severe isoimmunization.
 Side cell disease or other hemoglobinopathies.
 Cyanotic heart disease
 Chronic renal disease.
PROCEDURE
 Women's bladder should be emptied (to protect comfort and avoid disruption).
 Provide semi fowler's position on left lateral position.
 BP should be checked to obtain baseline recordings.
 There are two methods of inducing contraction
 Nipple stimulation.
 Intravenous oxytocin administration.
Stimulation Test
 Nipple stimulation causes the neurohypophysis to release endogenous oxytocin.

 This method of producing natural or curing oxytocin awards the risks discomfort and
expenses associated with intravenous infusion of oxytocin.
 At the beginning of test warm wash clothes are applied to the breasts.
 Apply ointment for lubricating jelly to the nipples to prevent soreness.
 Women then stimulates her nipple by either rolling them or gently pulling them.
 Stimulation is initially unilateral.
 If contractions are inadequate women then stimulated both nipples for another 10
minutes.
 Is contractions are still inadequate intravenous oxytocin is used.
 Nipple stimulation provides adequate contraction approximately in 75% of women
using this method.
Oxytocin Challenge Test
 Administration of oxytocin to induce contractions is called oxytocin challenge test.

 A Venipuncture is done IV line is established and a very dilute solution of oxytocin
controlled by an infusion pump is administered by a piggyback set up to another bag
of intravenous solution.
 The rate of inflation is increased at intervals until their contractions are occurring at a
frequency of at least three in a minute period and lasting at least 30 seconds.
 The recordings are interpreted and the infusion is stopped.
 Both the monitoring and the intervention solution, without oxytocin in it, are
continued until the contractions have diminished their baseline activity.
 This is to ensure that the OCT has not put the common into labour without knowing
about it.
Negative CST
 Negative CST is one in which no late deceleration occurs with contractions as

frequent as there is a 10 minute period.
 A Negative CSC indicates fetal well being and predicts that foetus will continue to be
alright for another week without needing the intervention of delivery if women's
clinical values does not change.
 Negative CST are repeated weekly of Sooner depending on the continuing clinical
status.
Positive CST
 A positive CST is one in which there have been repeated late deceleration of fetal
heart rate patterns during the test.
 A positive CST indicates that foetus me not with stand continuation of pregnancy
serious consideration need to be given to immediate termination of pregnancy by
delivery.
 A positive CST is a valuable piece of information in decision making but urge caution
and encourages use of a total picture of assessment methods and clinical judgement as
there can be at 25% rate false positive result.

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CONTRACTION STRESS TEST

 Contraction decreases the blood flow throughout the intravillus space.

INDICATIONS FOR CST

 Post maturity (suspected or actual)

 Nipple stimulation causes the neurohypophysis to release endogenous oxytocin.

Oxytocin Challenge Test

 Administration of oxytocin to induce contractions is called oxytocin challenge test.

 Negative CST is one in which no late deceleration occurs with contractions as

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