الفهرس 
Subject and methodsOnly 14 pages are availabe for public view
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Abstract
The present work investigated the extent to which
V A S test influences the clinical decision after screening
with NST in pregnant diabetic patients and whether the V A S
test adds information regarding the fetal outcome beyond
that provided by NST
Fifty diabetic and fifty non diabetic women (twenty
controlled and thirty uncontrolled) among those attending
the outpatient clinic of obstetrics and gynecology at Benha
university hospitals participated in this work during the
period from October 1991 to May 1993 •
Two hours-Postprandial blood glucose level <120 mg%
was the upper limit of blood glucose level control.Blood
glucose estimation was done on the same sitting of NST and V
A S test for diabetic cases twice weekly starting from 32
weeks until delivery Fetal outcome was reported as apgar
score at 5 minutes.
The results showed that:
(1) NST was:
(a) Reactive in 88%
controlled diabetics,
diabetics.
(b) Suspicious in 8%
controlled diabetics,
diabetics.
of control
and 60%
cases, 75% of
of uncontrolled
of
and
control cases ,10% of
30% of uncontrolled
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(c) Nonreactive in 4% of control cases, 15% of
controlled diabetics, and 10% of uncontrolled
diabetics.
(2) positive predictive value of abnormal NST was 33.3% of
control cases, 40 % of controlled diabetics, and 33.3% of
uncontrolled diabetics.
(3) V A S test was:
(a) Normal in 90% of control cases, 75% of controlled
diabetics, and 70% of uncontrolled diabetics.
(b) Abnormal in 10% of control cases, 25% of
controlled diabetics, and 30% of uncontrolled
diabetics.
(4) positive predictive value of V A S test was 40% of
control cases, 20% of controlled diabetics, and 44.4% of
uncontrolled diabetics.
(5) Suspicious NST was interpretated as normal after V A S
in 50% of control cases, 50% of controlled diabetics, and
66.67% of uncontrolled diabetics.
(6) Non reactive NST was interpretated as normal after V A S
in 50% of control cases, 33.3% of controlled diabetics, and
33.3% of uncontrolled diabetics.
(7) Apgar Score < 7 at 5 minutes was detected in 4% of
control cases, 10% of controlled diabetics, and 16.7% of
uncontrolled diabetics.
(8) No stillbirth or perinatal deaths were reported.
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On the basis of these findings:
(1) Reactive non stress test (NST) could predicts
intrauterine fetal well-being and good fetal outcome as
judged by apgar score at 5 min., provided that delivery
occurred within 3 days of test performance , no accidental
acute events had occurred within these 3 days and no
intrapartum complications.
(2) Suspicious non stress test could be considered as
compensated fetal distress or as sleeping- induced pattern,
and in this case,vibroacoustic stimulation by use of an
artificial larynx is required to arouse the fetus.
(3) Non reactive non stress test has a high false rate of
fetal distress prediction and so that it could not be based
upon alone for diagnosis of fetal distress or timing of
delivery in diabetic pregnancy.
(4) vibroacoustic stimulation eliminates the sleeping
rhythm-induced false philological non stress test and
therefor, improves the efficacy of non reactive NST in the
prediction of fetal compromise but still we can not based
upon it as an indication of termination of pregnancy on the
sole of fetal compromise which must be furtherly estimated
by other methods of antenatal fetal well-being assessment
before arrangement for planned delivery.
(5) There is no correlation between hyperglycemia and the
non stress test efficacy in diabetic pregnancies .