Maternal - Vaginal examination, nst, cst

Vaginal Examination

an internal physical examination done by a doctor or midwife.

Vaginal Examination

Systematic examination to assess the status of the vagina, vulva, cervix, uterus, ovaries and fallopian tube.

Bimanual Vaginal Examination

The health care provider inserts two fingers into the vagina and then places pressure with the other hand to the lower part of the belly.

Fornix / Fornices

are the superior portions of the vagina, extending into the recesses created by the vaginal portion of cervix.

Speculum vaginal examination

This uses a metal or plastic instrument shaped a little like a duck’s bill. The woman needs to lie on her back on the bed and rest comfortably with her knees bent.

Speculum / vaginal speculum

A medical instrument that widens your vaginal walls so that your provider can examine your vagina and your cervix. It’s most commonly used during pelvic exams and Pap smears, but it’s used in many other gynecological procedures, too.

Non stress test

A test that does not put the patient or the baby under any stress to perform the procedure, it is just monitoring what the baby is doing.

Non stress test

a simple, non invasive way of checking the baby’s health. Sometimes called a cardiotocography. It records the baby’s movement, heartbeat and contractions.

Who needs non stress test?

Has medical conditions such as type 1 diabetes, high blood pressure, heart disease, experiences decreased fetal movement, is 2 or more weeks past-due.

2 transducers used for non stress test

Ultrasound transducer and tocotransducer

Use of ultrasound transducer for NST

to record fetal heart rate activity, is secured over the spot on the woman’s abdomen where fetal heart is heard most clearly.

Use of tocotransducer for NST

detects uterine activity and fetal movement, is secured to the maternal abdomen.

Reactive test result (NST)

when the fetus heart rate accelerates or increases when it moves or when the patient have contractions. It must react 2 times within a 20 min testing period to get active result.

Nonreactive test result (NST)

if the baby’s heart rate does not increase to the expected level. This could happen if the baby is asleep or not active.

Nonreactive test result (NST)

an abnormal test is sometimes associated with adverse fetal or neonatal outcomes usually associated with neurologically intact and inadequate oxygenated fetus.

False-positive test result

a normal well oxygenated fetus may not exhibit movement for more than 20 minutes, primarily because of the sleep-wake cycle. Result may be interpreted as non reactive when in fact the baby is healthy but asleep.

Contraction stress test (CST)

or oxytocin challenge test measures fetal heart rate during late pregnancy or labor to induce contractions and ensure oxygen supply. Usually done around 34 weeks of pregnancy.

Range of fetal heart rate

110-160bpm

2 types of CST

Nipple stimulation and oxytocin challenge test

Nipple stimulation

The doctor may ask you to stimulate the nipples to release oxytocin in the body and trigger contractions naturally.

Oxytocin challenge test

if the contractions do not start on their own within 15 mins, then small does of oxytocin (Pitocin) is given through IV.

Negative contraction stress test

when there are no decelerations in the fetal heart rate during contractions

Positive contraction test

if more than half of the contractions indicate late decelerations in the fetal heart rate