Beruflich Dokumente
Kultur Dokumente
POLICY
Obstetricians order a Contraction Stress Test (CST) for an atypical Nonstress Test (NST) and/or for
concerns about fetal well-being and assessment of fetal ability to tolerate labour. The contraction stress
test should be considered in the presence of an atypical non-stress test as a proxy for the adequacy of
intrapartum uteroplacental function and, together with the clinical circumstances, will aid in decision making
about timing and mode of delivery. A CST should NOT be performed when a vaginal delivery is
contraindicated.
Registered Nurses (RN) certified in fetal health assessment perform and interpret electronic fetal
monitoring tracings and report the results to the obstetrician.
The CST may be performed using an oxytocin infusion (Oxytocin Challenge Test, or OCT), or by maternal
nipple stimulation
Applicability: CST’s occur in Labour & Delivery area in the Maternal Newborn Program.
PROCEDURE
The test is complete when this uterine contraction pattern (3 contractions lasting one minute each within a
10 minutes period) is achieved. It is not necessary to increase this frequency.
Check the fetal heart rate (FHR) tracing and uterine activity recording is interpretable and is continuous on
both channels.
Registered Nurse
Physician - Interpret the CST/ OCT as positive, negative or equivocal and determine the next steps in
care.
Negative Positive Equivocal
Plan for further fetal surveillance Plan to proceed with delivery Plan to repeat CST within 24
as indicated by maternal/ fetal by: hours, if appropriate
condition Induction of labour Or
Or Or use other methods of fetal
Order induction of labour Cesarean delivery* assessment
*Note: A fetus demonstrating an atypical/ abnormal NST and a positive CST/OCT is less likely to tolerate
labour and will require careful intrapartum observation.
DOCUMENTATION
Fetal Monitor Label and Fetal Heart Tracing
Fluid Balance Record – 12 Hour
Labour Partogram
Medication Added Label
Physician’s Orders
REFERENCES
Kavanagh, J. Thomas, J (2005) Breast stimulation for cervical ripening and induction of labour (review)
Cochrane Database of Systematic Reviews Issue 3
Liston, R., Sawchuk, D., Young, D., (2007, September). Fetal Health Surveillance: Antepartum and
Intrapartum Consensus Guideline No.197. SOGC. JOGC Vol 29(9) Supplement 4.
http://www.sogc.org/guidelines/documents/gui197CPG0709r_000.pdf
Miller, D (2018) Nonstress test and contraction stress test UpToDate Accessed June 20 2018
www.uptodate.com/contents/nonstress-test-and-contraction-stress-test Last updated Jan 2018
VERSION HISTORY
DATE DOCUMENT NUMBER and TITLE ACTION TAKEN
26-June- WW.04.05 Contraction Stress Test Approved at: BC Women’s Hospital Acute Perinatal Program
2018 (Oxytocin Challenge Test) Best Practice Committee
DISCLAIMER
This document is intended for use within BC Children’s and BC Women’s Hospitals only. Any other use or reliance is
at your sole risk. The content does not constitute and is not in substitution of professional medical advice. Provincial
Health Services Authority (PHSA) assumes no liability arising from use or reliance on this document. This document is
protected by copyright and may only be reprinted in whole or in part with the prior written approval of PHSA.
WW.04.05 Published Date: 30-Jul-2018
Page 3 of 3 Review Date: 30-Jul-2021
This is a controlled document for BCCH& BCW internal use. Refer to online version. Print copy may not be current. See Disclaimer at the end of the document.