Contraction Stress Test

Aka: Contraction Stress Test, Oxytocin Challenge Test

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II. Cost: $250

III. Technique

  1. Oxytocin (Pitocin)
    1. Start: 0.5 to 1.0 mU per minute
    2. Titrate: increase 1 mU every 20 minutes
    3. Goal: 3 Contractions every 10 minutes
  2. Nipple Stimulation

IV. Contraindications

  1. Absolute
    1. Placenta Previa
    2. Preterm Prolonged Rupture of Membranes (PPROM)
    3. Cerclage
    4. Incompetent Cervix
  2. Relative
    1. Multiple Gestation
    2. History of classic Cesarean Section

V. Interpretation

  1. Negative (Normal)
    1. Adequate contractions:
      1. Three contractions in 10 minutes
      2. Each contraction lasts 40 seconds
    2. No Late Decelerations
  2. Positive
    1. Repetitive, persistent Late Decelerations
    2. Decelerations with more than half of contractions
    3. Not due to uterine hyperstimulation

VI. Management

  1. Negative Contraction Stress Test
    1. Reassuring for fetal well being for 7 days
    2. Follow daily Fetal Kick Counts
  2. Positive Contraction Stress Test
    1. Hasten fetal delivery

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