title: Fetal acoustic stimulation test for early intrapartum fetal monitoring.
abstract: BACKGROUND
  The fetal acoustic stimulation test (FAST) is a simple cost effective screening test for antenatal fetal monitoring. The aim of the study was to evaluate the FAST as a screening test for early intrapartum fetal well being.
  
  
  METHODS
  An initial non stress test (NST) followed by a FAST using corometric model 146 was carried out in 486 participants in early labour with uncomplicated singleton pregnancies and > 32 weeks gestation. A repeat NST was recorded in the participants who had an initial non reactive NST. The results of the NST and FAST were compared with fetal outcome. Maternal perception of fetal movements after FAST, results of NST before and after FAST, and the babies' 5 minute APGAR scores were measured.
  
  
  RESULTS
  Of the 486 participants 413 (85%) noticed fetal movements after FAST. Initial NST was non reactive in 203 (42%) but 149 (31%) became reactive after FAST. Compared to the NST, FAST had a better sensitivity (97% vs 62%, p < 0.001), specificity (100% vs 87%, p = 0.017), positive predictive value (100% vs 98%, p = 0.024), negative predictive value (79% vs 17%, p < 0.001) and accuracy (99%vs 64%, p < 0.001) in predicting 5 minute APGAR < 7 in the baby.
  
  
  CONCLUSIONS
  FAST is a reliable screening test for assessing fetal well being in early labour. It complements the NST and is better than the NST alone.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. malikg@eureka.lk
authors.forename: M
authors.initials: M
authors.lastname: Goonewardene
authors.forename: K
authors.initials: K
authors.lastname: Hanwellage
mesh_terms: D000161:Acoustic Stimulation; D001034:Apgar Score; D005260:Female; D005311:Fetal Hypoxia / Q000175:diagnosis* / Q000517:prevention & control; D005323:Fetal Monitoring / Q000379:methods*; D005324:Fetal Movement; D005333:Fetus; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D011247:Pregnancy; D011256:Pregnancy Outcome; D012680:Sensitivity and Specificity; D014219:Trial of Labor