Antepartum heart rate testing in diabetic pregnancy.
Fetal death in utero remains a significant contributor to diabetics' perinatal mortality despite the reassuring results of antepartum heart rate testing. We retrospectively reviewed 48 pregnancies (one set of twins) of class B-F diabetic women with a reactive nonstress test (NST) or a negative contraction stress test (CST) within one week of delivery. Four fetal deaths occurred four to seven days after the test; no fetal deaths occurred within three days of it. We advocate initial screening with the NST, followed by a CST if the NST is nonreactive. Testing should be done more often than weekly.
D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000517:prevention & control; D005323:Fetal Monitoring; D006339:Heart Rate; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications / Q000503:physiopathology*; D011295:Prenatal Care; D012189:Retrospective Studies; D014590:Uterine Contraction