Frequency of NSTs?

Hi All.. I am 31 weeks and starting my NSTs next week, so wondering how often NSTs are required for T1s in good control/ no complications for the rest of pregnancy?

I'm asking as am getting conflicting info form a high risk doc (NOT myusual guy) who said I needed TWICE weekly NSTs from 32 weeks on...this seems kind of crazy to me not to mention incredibly difficult with work, etc. If that's truly what's required, I will of course, make it work. But given baby and mom are on track in terms of growth, etc, I am wondering why it would be needed so often...?

My regular OB (who also deals with high risk patients primarily) said starting at 32 weeks, once/week was sufficient as no issues presently. Then I guess they become more frequent after 36? Guess I need to get clarification from my doc as is always alot of info to absorb and I am confused...Any clarificatrion would be great!

Thanks. Megan

Hi Megan:

I was told early on that I would have to come twice a week from week 32 on.  It just so happened that I've been going twice a week since week #30 because we had a couple of non-responsive non-stress tests - so my dr. had me come back to make sure everything was OK (and it was thank goodness).  When and if you happen to get a non-responsive non-stress test, they will send you for a biophysical profile ultrasound where they measure several things.  Movement, breathing, amniotic fluid etc.  It's out of a score of 8 (it's really out of 10, but 2 points come from the NST, so if you don't pass that it's out of 8...which is why you' be sent for the biophysical profile ultrasound in the first place...anyway) When we got the two non-responsive non-stress tests my dr. said if I didn't get 8/8 to come back and see him (not sure what would have happened if we didn't get 8/8...he mentioned coming back later in the day to check again...or possibly sending me to the hospital for them to monitor), but thankfully we passed with 8/8 both times so far. 

I think you and I are about a little over a week or so apart right now.  I'm about to start week #33 on Friday....which is when my next NST is as well as an ultrasound so they can do measurements.  I am exicted to find out how much the baby weighs now...she was 3 lbs. 8 oz back on 3/17, so hopefully our little angel has packed on some weight!  :o)  The Dr. used a measuring tape yesterday to measure my belly and said I was right on target.  My most recent Hemoglobin A1c was 5.4 and I am in the best control of my life.  He said I was doing a good job and it made me feel really good.  How have your numbers been?

I asked yesterday at my appointment what was next as far as the testing goes and the dr. told me that week 35 they will do the strep B test...which from what I have heard is similar to a pap test. 

As far as the non-stress tests becoming more frequent after 36 weeks...I haven't heard that from my dr., but I suspect if there were several non-responsive ones, they would probably send you for monitoring more frequently.  Are you going to be induced?  I was told from the beginning that I will be induced and we just talked about dates for the "main event" yesterday.  I'll go for an amniocentsis on 5/14 and then if everything is OK with that (they check for lung maturity before induction) they will induce on 5/17. 

Good luck with your tests!  Let me know how it goes!

~Nicki :o)

The new recommendation from the College of Obstetrics is NST's twice a week for high risk pregnancies. With my daughter in 2007, I had one a week from 30 weeks. I was induced at 35 weeks due to low amniotic fluid. With my son, 8 months ago, I had NST's twice a week from week 28. I ended up having planned C-sect at 38 weeks. I think twice a week is the "new" standard. 

Katie:

How low was your amniotic fluid?  I went to the Dr. for an ultrasound this morning as well as a non-stress test and the baby measured approx. 4 lbs. 4 oz.  they told me everything was "average", but then when the dr. looked at the ultrasound report, he said that she was on the "lower side" and that the amniotic fluid was slight low, but "not to worry" he would check it again in 2 weeks (which would actually be my week 35).  Easy for him to say for me not to worry!!  Just wondered what your experience was...thanks!

~Nicki :o)

 

 

Nicki-

At 34 weeks I was close to 10cm... then at 35 weeks I was down to 8... they ended up admitting me to the hospital on bedrest and to monitor my fluid. After 48 hours of bedrest, my fluid had had dropped to 5cm, so they induced me and ended up doing a c-sect after 12 hours of really hard laboring. I delivered a big, fat, perfect baby girl at 35 weeks. I am very lucky to have such a great OB, if they would not have admitted me, and I would have returned for a check the week later, I would have had a stillborn...

I started with twice weekly NST's at 32 weeks.  I had my daughter at 37 weeks (in Oct 2008) - 3 weeks early because my placenta was beginning to degrade (which can result in a still born baby) and even though it wasn't at a critical situation yet, they didn't want to chance it.  I should mention that I was also in really great control with A1C's that ranged from 5.4 - 6.0 throughout my pregnancy.  My daughter was born healthy, so who knows what the cause was. 

Twice a week starting at 32 weeks is pretty standard, and I don't think I'd be comfortable with less often since they are only predictive of placental health for about 48 hours.  It can be a pain, but IMO its worth it to know that should anything start looking not quite right (even with great control, we have higher risks for that kind of stuff which is why they do these) they'll be able to pick it up soon enough to figure out what to do (early delivery, more often checks, etc).  Good luck!