title: Fetal startle response observed under ultrasonography: a good predictor of a reassuring biophysical profile.
abstract: OBJECTIVE
  To correlate the vibroacoustic stimulus-evoked fetal startle response observed under ultrasonography with the subsequent biophysical profile (BPP) score.
  
  
  METHODS
  Vibroacoustic stimulation was applied under ultrasound observation to gravidas who had a nonreactive fetal heart rate in the first 10 minutes of monitoring. Fetal startle response was defined as a sudden movement of fetal extremities in the 2 seconds following stimulus. Subsequently, nonstress testing was completed and a BPP performed on all women who required vibroacoustic stimulation. The presence or absence of a fetal startle response was compared with the observed BPP score.
  
  
  RESULTS
  Two hundred tests were performed at 35.3 +/- 3.7 weeks. After the vibroacoustic stimulation, 70% of the nonreactive tracings became reactive. Mothers perceived the fetal startle response after vibroacoustic stimulus in 93% of cases. All cases with a fetal startle response after a vibroacoustic stimulation had a subsequent BPP score of 8 or more (negative predictive value of 100%). In addition, all patients with a nonreassuring BPP score were in the group of patients with absent fetal startle response. However, the positive predictive value of an absent fetal startle response for a subsequent BPP score of 6 or less was only 10%.
  
  
  CONCLUSIONS
  This preliminary study suggests that the fetal startle response predicts a BPP score equal to or greater than 8. After the availability of larger studies supporting these findings, this test could be used as a rapid antepartum test to predict fetal well-being.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tennessee, Memphis, USA.
authors.forename: C
authors.initials: C
authors.lastname: Sarinoglu
authors.forename: J
authors.initials: J
authors.lastname: Dell
authors.forename: B M
authors.initials: BM
authors.lastname: Mercer
authors.forename: B M
authors.initials: BM
authors.lastname: Sibai
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D005314:Embryonic and Fetal Development; D005260:Female; D005324:Fetal Movement; D006801:Humans; D010812:Physical Stimulation; D011237:Predictive Value of Tests; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D013216:Reflex, Startle; D016216:Ultrasonography, Prenatal; D014732:Vibration