What is a contraction stress test?
A contraction stress checks the baby's heart rate when the
mother has a uterine contraction. During this test, the
baby's heart rate and the mother's contractions are
recorded.
Most contractions decrease the flow of blood and oxygen to
the baby for a short time. By seeing how the baby's heart
rate reacts to contractions, your health care provider can
tell if the baby will be able to handle the stress of the
contractions that occur during labor.
This test is also called an oxytocin challenge test.
When is a contraction stress test used?
This test may be done if:
- During a nonstress test the baby's heart rate did not
rise enough to be considered a reactive result. (A
nonstress test uses an external fetal monitor to look at
how the baby's heart rate changes when the baby moves.)
- The biophysical profile score is low. (For a biophysical
profile, an ultrasound scan is done with a nonstress
test.)
- Your health care provider knows or thinks that your
baby or you have a high-risk condition.
Often a biophysical profile may be done instead of a
contraction stress test.
How is a contraction stress test done?
You will lie on your left side with a strap and pressure
gauge around your abdomen. The gauge measures contractions
of the uterus. An ultrasound transducer will be placed on
your abdomen over the baby's heart. It measures your baby's
heart rate. Your blood pressure and the baby's heart rate
will be monitored for several minutes before the test
begins.
For the test to be valid, you must have contractions that
are strong and frequent enough to be similar to the first
phase of labor. If you are not having contractions that are
strong and frequent enough, you may be asked to stimulate
your breasts by placing a warm compress on one of them or by
rubbing a nipple. This causes the your body to release
oxytocin, which can make your uterus contract. If these
methods do not cause enough good contractions, your health
care provider may give you a very small amount of oxytocin
through a vein (IV) until you have 3 contractions in 10
minutes.
How is the test interpreted?
Your provider will look at how often the baby's heart rate
slows and when during a contraction it slows.
- If the baby's heart rate does not fall during the
contractions, the result of the test is negative, which
is reassuring. It suggests that the baby is healthy.
- If the baby's heart rate falls during a contraction, the
test may be interpreted as positive and nonreassuring.
This may mean that the baby is having some problem and
there is a chance the baby will have more serious
problems during labor. However, it is important to
remember that not all lowering of the heart rate during a
contraction means the baby may have a problem. The test
has to be read by your health care provider based on the
situation and circumstances of the test.
What happens after a contraction stress test?
A result that is not clearly positive or negative should be
repeated in 24 hours.
If you have a positive stress test, you will probably be
admitted to the hospital. If your baby is having a problem
that cannot be corrected, your health care provider may want
to deliver the baby early with a cesarean section.
What are the risks of a contraction stress test?
The stress test can cause some women to start labor. For
this reason it is not done if you are at risk of going into
premature labor.
The test could cause too many uterine contractions,
especially if you are given oxytocin to stimulate the
contractions. Oxytocin is given slowly and carefully, but
in some cases it can stimulate too many contractions and has
to be stopped.
Your health care provider also may not use this test if:
- You had a previous cesarean section with a vertical
incision of the uterus.
- There is a chance that the placenta will separate from
the uterus early (placental abruption).
- You have more than one baby in the uterus.
- The placenta is low in the uterus (placenta previa).
- You have premature rupture of your membranes (your bag of
waters has broken).


Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
HIA File WOM5312F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.
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