ASSESSMENT OF FETAL WELL-BEING USING THE NONSTRESS TEST IN THE HOME SETTING

Objective: To determine the feasibility of performing nonstress tests (NSTs) in the home setting instead of the health clinic environment. M ethods: In this prospective study, ten women were tested using a Sonic aid TEAM portable monitor and a Hewlett-Packard device in the health c linic. The women were then instructed on use of the Sonicaid device an d were tested once a week in the home as well as in the high-risk clin ic. All tests were reviewed independently by two of the authors to ass ess agreement in interpreting the NST. In the health clinic setting, a nonreactive NST was followed by a nipple stimulation contraction stre ss test (CST); in the home, a nonreactive NST was followed by maternal voice acoustic stimulation. Results: There was 100% correlation durin g the concurrent study. Two blinded authors agreed on all tests. Durin g the second phase, eight of the ten subjects had NSTs that were consi stently reactive in both the home and office settings. In one woman, a nonreactive NST in the clinic was followed by a negative CST. In the remaining patient, a reactive NST in the health clinic was followed 3 days later by a nonreactive NST in the home, which persisted in the pr ovider's office. Conclusion: Nonstress testing in the home appears to be an accurate method of antenatal fetal health assessment that adds c onvenience and potential cost savings.