Methods for assessing the well-being of the fetus in the uterusare constantly being improved and the appearance of new tests is quite a common occurrence. At the same time, each clinic and each doctor has some specific devices and methods for determining the fetus's well-being. The most frequently used methods (tests) are listed below. Evaluation of fetal movements can allow one to judge the fetus's well-being, while being the simplest way to detect any danger that has arisen. If the pregnant woman does not feel the fetus's movements, other studies are necessary.

Test for absence of pathology

Test for absence of pathology -non-stress test. This test is quite safe and is the most accessible. It is based on the following observation: a healthy child's heart rate increases by approximately 15 beats over 15 seconds during movement, provided that there is a normal oxygen supply. The heart rate is recorded during an ultrasound examination. The doctor asks the mother to say when she feels the child move. From this moment on, the heart rate is monitored. If a change in heart rate is observed twice within 20 minutes, the result is considered normal. If no increase in heart rate is observed within 40 minutes, the result is considered pathological. A positive result corresponds to the normal state of the fetus, however, with a negative result, in 75% of cases the alarm is false. For example, the child may be sleeping during the test. If the test is repeated after some time, the result will be normal. If the repeated analysis also indicates a stressful state of the fetus, the doctor may prescribe a test for pathological contractions for verification. Acoustic or vibroacoustic stimulation - a non-stress test that evaluates the fetus's response to sound or vibration.

Test for the pathology of contractions

Test for pathology of contractions - research,used to assess the effect of uterine spasms on fetal heartbeat. These studies are more complex and require more time (can last up to 3 hours). If spasms do not occur on their own often enough, they can be induced by intravenous oxytocin or by stimulating the nipples (using a hot towel or the pregnant woman's hand). The fetus's response to spasms reliably determines the condition of the child and placenta. A negative or reassuring result means that the child's heartbeat remains normal during contractions. A positive or alarming result means that there is a pathology of the heartbeat during or after contractions, i.e. there is a risk of the child being in prolonged contractions. It has been found that nipple stimulation or oxytocin injection give the same results. However, nipple stimulation is much simpler, cheaper and faster. A woman can periodically stimulate her nipples herself by rubbing them with her fingertips through clothing for 2 minutes every 5 minutes. This test has a very high percentage of false positives. Therefore, an assessment of the condition of the fetus can only be made on the basis of a few tests.

Biophysical profile

Biophysical profile.This forty-minute procedure combines an ultrasound test for normal fetal health and a check of the baby’s general condition: reactive heartbeat, breathing, muscle tone in the limbs, body movement, and the amount of amniotic fluid. The baby is given a score of 0-2 for each of the five listed items, similar to the Apgar scale. A high score (8-10) means the baby is healthy. A low score (0-2) means the baby’s life is in danger. The doctor may then suggest immediate delivery. High and low scores are fairly accurate in reflecting the baby’s condition. But the intermediate value (3-6) is much more difficult to interpret. Although the results of this test are not definitive, it is one of the safest ways to check the baby’s intrauterine condition. “Modified” biophysical profile. This is a combination of a biophysical profile study and a non-stress test. This allows for an accurate assessment of the baby’s condition.

Fetal blood test

Fetal blood test.If hypoxia (lack of oxygen) is suspected, the baby's blood is taken for analysis. After the amniotic sac is ruptured, the doctor inserts a thin tube into the cervix and attaches it to the baby's skull. A small puncture is made on the scalp and a blood sample is taken. If the oxygen concentration in the blood is normal, then the baby is fine. The baby's blood test helps to avoid misinterpretation of the monitor readings during EMF, and also allows the doctor to avoid hasty and unjustified intervention. In some maternity hospitals, the equipment for analyzing the baby's blood is located near the delivery room, so that the results can be obtained without delay (otherwise, the blood test takes about 20 minutes). The longer the time between taking the blood and receiving the results, the less important the test is for making a decision about intervention.

Volume of amniotic fluid

Volume of amniotic fluid.Amniotic fluid acts as a cushion for the baby, allows it to move, helps the lungs develop, stabilizes the baby's body temperature, and serves as a barrier to infection. This fluid comes from two sources: the mother's and the baby's bodies. Some of it comes from the mother's blood serum, and some is secreted by the baby's kidneys and lungs. Most of the amniotic fluid is fetal urine. In the last month of pregnancy, the amniotic fluid is replenished with fetal urine in the amount of 30 ml per hour. In the last weeks of pregnancy, the volume of amniotic fluid usually decreases. The volume of amniotic fluid is maintained in equilibrium as a result of constant replenishment and absorption. If the balance is disturbed, too much (polyhydramnios) or too little (oligohydramnios) fluid is formed. In both cases, there is a danger to the fetus. For example, oligohydramnios may mean that the baby's kidneys are not working well and producing too little urine. A sharp decrease in the volume of amniotic fluid before childbirth is especially dangerous. If this occurs against the background of other signs of a pathological condition of the fetus, it becomes a reason for intervention. However, since ultrasound determination of the amount of amniotic fluid does not provide accurate results and its amount can be affected by many factors, this test alone does not provide a clear decision on intervention. There are many other tests for assessing the condition of the fetus: sequential ultrasound examinations assessing the continuous growth of the fetus, collection of amniotic fluid (by amniopuncture), assessment of the volume of blood passing through the umbilical cord, rapid fetal assessment test upon admission to the maternity ward (combining an acoustic test with an assessment of the amount of amniotic fluid), fetal electrocardiography (assessment of the fetal heart function using an electrode placed on the fetal head), fetal head stimulation test (assessment of the fetal head's response to compression and injections). However, the need for using a particular test is determined by many objective reasons. We recommend reading:

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