title: Comparison of the manual stimulation test and the nonstress test: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate manual fetal stimulation (MST) through the maternal abdomen in comparison to standard nonstress test (NST) in terms of nonreactive rates and testing time.
  
  
  METHODS
  Five hundred and forty high-risk singleton pregnancies at 28 gestational weeks or more were assigned to have either NST or MST using blocked randomization (270 each). All fetal heart rate (FHR) tracings were analyzed blindly using standard NST criteria by one perinatologist.
  
  
  RESULTS
  The MST group provided a significantly higher reactive rate than that of the NST group, 98.9% and 84.4% respectively, p < 0.001. Mean testing time of the reactive results of the MST group was also significantly shorter than that of the NST group, 7.94 +/- 6.27 min and 13.91 +/- 9.58 min respectively, p < 0.001.
  
  
  CONCLUSIONS
  This is the first randomized controlled trial (RCT) to demonstrate the distinctive benefit of the simple and less expensive MST. MST significantly reduces the time to reactivity and increases the frequency of reactivity when compared to NST alone.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd, Sripoom, Mueang, Chiang Mai 50200, Thailand. wpiyamon@mail.med.cmu.ac.th
authors.forename: Wirawit
authors.initials: W
authors.lastname: Piyamongkol
authors.forename: Sompong
authors.initials: S
authors.lastname: Trungtawatchai
authors.forename: Pharuhas
authors.initials: P
authors.lastname: Chanprapaph
authors.forename: Theera
authors.initials: T
authors.lastname: Tongsong
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011296:Prenatal Diagnosis; D011446:Prospective Studies