Can Maternal Exercise Be Used to Test Fetal Reserves? [21I]

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Abstract

INTRODUCTION:

Currently, contraction stress test (CST) is the only one to assess fetal reserves. However, CST has limited use since its time consuming, requires IV placement, and can put patient in labor. We propose a new test to assess fetal reserves—a FHR response to maternal exercise (FRME).

METHODS:

640 term patients underwent FRME for accepted clinical indications. Total amount of tests was 1,680. All tests were performed using motorized treadmill in the moderate exercise regimen (15 minutes fast walk at a speed of 3 mph with an incline of 15 to 25°). The research protocol was approved by the IRB committee. Monitoring was provided by using Philips (Avalon CTS, FM40) equipment. The primary outcome was a composite of intrapartum fetal death, neonatal death, an Apgar score of 3 or less at 5 minutes, neonatal seizure, an ABG of pH of 7.05 or less with a BE of 12 mmol per liter, intubation for ventilation at delivery, or neonatal encephalopathy. FET like an CST was interpreted as negative (absents of decelerations, possible presence of accelerations), positive (presence of late decelerations or sustained bradycardia) or inconclusive.

RESULTS:

FET results have been classified in 3 separate categories: negative, positive, and inconclusive. 1,506 tests were interpreted as negative, 58 positive, 312 inconclusive. FET results Incidence of adverse outcome Negative 2% Positive 14% Inconclusive 4%.

CONCLUSION:

It appears that similar to CST, positive FRME has a high correlation with adverse perinatal outcome.

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