同: OCT

WordNet

issue a challenge to; "Fischer challenged Spassky to a match"
a demanding or stimulating situation; "they reacted irrationally to the challenge of Russian power"
a call to engage in a contest or fight
a demand by a sentry for a password or identification
a formal objection to the selection of a particular person as a juror
questioning a statement and demanding an explanation; "his challenge of the assumption that Japan is still our enemy"
take exception to; "She challenged his claims" (同)dispute, gainsay
raise a formal objection in a court of law (同)take exception
ask for identification; "The illegal immigrant was challenged by the border guard"
undergo a test; "She doesnt test well"
any standardized procedure for measuring sensitivity or memory or intelligence or aptitude or personality etc; "the test was standardized on a large sample of students" (同)mental test, mental testing, psychometric test
the act of undergoing testing; "he survived the great test of battle"; "candidates must compete in a trial of skill" (同)trial
the act of testing something; "in the experimental trials the amount of carbon was measured separately"; "he called each flip of the coin a new trial" (同)trial, run
a hard outer covering as of some amoebas and sea urchins
put to the test, as for its quality, or give experimental use to; "This approach has been tried with good results"; "Test this recipe" (同)prove, try, try out, examine, essay
achieve a certain score or rating on a test; "She tested high on the LSAT and was admitted to all the good law schools"
determine the presence or properties of (a substance)
show a certain characteristic when tested; "He tested positive for HIV"
an examination of the characteristics of something; "there are laboratories for commercial testing"; "it involved testing thousands of children for smallpox"
the act of subjecting to experimental test in order to determine how well something works; "they agreed to end the testing of atomic weapons"
stimulating interest or thought; "a challenging hypothesis"; "a thought-provoking book" (同)thought-provoking
disturbingly provocative; "an intriguing smile" (同)intriguing
tested and proved useful or correct; "a tested method" (同)tried, well-tried
tested and proved to be reliable (同)time-tested, tried, tried and true

PrepTutorEJDIC

〈U〉〈C〉『挑戦』,試合の申し込み;〈C〉挑戦状 / 〈U〉(番兵などが怪しい者に)“だれか"と呼び掛けること / 〈C〉手ごたえのある事(物) / 〈U〉〈C〉(…への)異議申し立て抗議《+『to』+『名』》 / 〈U〉〈C〉(陪審員に対する)忌避 / (競技・決闘などを)〈人〉‘に'『挑む』,挑戦する / …‘に'『異議を申し立てる』 / 〈物事が〉〈人〉'を'奮起させる,〈興味など〉'を'呼び起こす / 〈番兵・守衛などが〉…‘に'“だれか"と呼び掛ける / 〈陪審員・裁判官〉'を'忌避する
(人の能力などの)『試験』,考査,テスト / (物事の)『試験』,検済,試錬,実験《+of+名》 / 化学分析;試薬 / =test match / …‘を'『試験する』,検査する / …‘を'化学分析する / (…の)試験を受ける,試験をする《+for+名》
挑戦的な / 興味をそそる,魅力的な

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/12/17 10:55:17」(JST)

wiki en

A contraction stress test (CST) is performed near the end of pregnancy to determine how well the fetus will cope with the contractions of childbirth. The aim is to induce contractions and monitor the fetus to check for heart rate abnormalities using a cardiotocograph.

Principle[edit]

During uterine contractions, fetal oxygenation is worsened. Late decelerations in fetal heart rate occurring during uterine contractions are associated with increased fetal death rate, growth retardation and neonatal depression.^[1]^[2] This test asseses fetal heart rate in response to uterine contractions via electronic fetal monitoring. Uterine activity is monitored by tocodynamometer.^[3]

Procedure[edit]

CST is performed weekly,^[1] as the fetus is assumed to be healthy after a negative test and should remain so for another week.^[4] This test is done in hospital or clinic setting.^[3] External fetal monitors are placed. Either nipple stimulation or IV pitocin (oxytocin) is used to stimulate uterine contractions.

Nipple Stimulation[edit]

This is a procedure that relies on endogenous release of oxytocin following nipple stimulation, and is conducted by the patient. The nurse instructs the patient on the procedure, as follows. One nipple is massaged gently through clothing until a contraction begins, or for a maximum of 2 minutes. If at least 3 contractions in 10 minutes is not achieved, then the patient rests for 5 minutes and the other nipple is stimulated.^[5]^[6]

Oxytocin Challenge Test (OCT)[edit]

If adequate contractions (at least 3 in 10 minutes) cannot be achieved with nipple stimulation, an oxytocin challenge test may be performed. It involves the intravenous administration of exogenous oxytocin to the pregnant woman. The target is to achieve around three contractions every ten minutes.^[5]^[6]

Interpretation[edit]

Result	Interpretation
Positive	Presence of late decelerations with at least 50% of the contractions^[7]
Negative	No late or significant variable decelerations,^[7] with at least 3 uterine contractions (lasting 40 seconds) in 10 minute period.^[8]
Equivocal—Suspicious	Presence of late decelerations with fewer than 50% of contractions or significant variable decelerations. Requires repeat testing on following day.^[1]
Equivocal—Tachysystole	Presence of contractions that occur more frequently than every 2 minutes or last longer than 90 seconds in the presence of late decelerations. Requires repeat testing on following day.^[1]
Equivocal—Unsatisfactory	Fewer than three contractions occur within 10 minutes, or a tracing quality that cannot be interpreted. Requires repeat testing on following day.^[1]

Results & Efficacy[edit]

The CST is used for its high negative predictive value. A negative result is highly predictive of fetal wellbeing and tolerance of labor. The test has a poor positive predictive value with false-positive results in as many as 30% of cases.^[6]^[9] A positive CST indicates high risk of fetal death due to hypoxia^[3] and is a contraindication to labor. Patient's obstetricians usually consider operative delivery in such situations.^[10]

Contraindications[edit]

This "stress test" is usually not performed if there are any signs of premature birth, placenta praevia, vasa praevia, cervical incompetence, multiple gestation, previous classic caesarian section.^[1] Other contraindications include but are not limited to previous uterine incision with scarring, previous myomectomy entering the uterine cavity, and PROM. Any contraindication to labor is contraindication to CST.

History[edit]

The CST was the first antenatal surveillance test that was developed after the development of the cardiotocograph.^[6] The oxytocin challenge test was first described in 1972^[11] and was standardised in 1975 when the parameters of contraction number and frequency were given.

Historically, a CST was done after a non reactive NST. Today, a biophysical profile (BPP) is usually performed.

References[edit]

^ ^a ^b ^c ^d ^e ^f Danforth's obstetrics and gynecology (10th ed. ed.). Philadelphia: Lippincott Williams & Wilkins. 2008. p. 161. ISBN 9780781769372.
^ Current diagnosis & treatment : Obstetrics & gynecology (10th ed. ed.). New York: McGraw-Hill. 2007. p. 255. ISBN 978-0-07-143900-8.
^ ^a ^b ^c III, Frances Talaska Fischbach, Marshall Barnett Dunning (2009). A manual of laboratory and diagnostic tests (8th ed. ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 1030–31. ISBN 9780781771948.
^ Munden, ed.: Julie (2005). Professional guide to diagnostic tests. Philadelphia: Lippincott Williams & Wilkins. p. 682. ISBN 9781582553047.
^ ^a ^b American College of Obstetricians and Gynecologists (ACOG). (1999). Antepartum fetal surveillance (Practice Bulletin No. 9). Washington, DC: Author.
^ ^a ^b ^c ^d Association of Women’s Health, Obstetric, and Neonatal Nurses (2005). Audrey Lyndon, Linda Usher Ali, ed. Fetal Heart Monitoring: Principles and Practices (3rd ed.). Dubuque, IA: Kendall/Hunt Publishing Co. ISBN 978-0-7575-6234-1.
^ ^a ^b Evans, [edited by] Arthur T. (2007). Manual of obstetrics (7th ed. ed.). Philadelphia: Wolters Kluwer / Lippincott Wiliams & Wilkins. p. 587. ISBN 9780781796965.
^ Anderson, edited by Jean R. (2005). A guide to the clinical care of women with HIV (2005 ed. ed.). Rockville, MD: U.S. Dept. of Health & Human Services, Health Resources & Services Administration, HIV/AIDS Bureau. p. 270. ISBN 9780160726118.
^ Lagrew DC, Jr (1995 Mar). "The contraction stress test.". Clinical obstetrics and gynecology 38 (1): 11–25. PMID 7796539. Check date values in: |date= (help); |accessdate= requires |url= (help)
^ First aid for the family medicine boards. New York: McGraw-Hill Medical. 2008. p. 556. ISBN 0-07-159382-9.
^ Ray M, Freeman R, Pine S, Hesselgesser R (September 1972). "Clinical experience with the oxytocin challenge test". Am. J. Obstet. Gynecol. 114 (1): 1–9. PMID 4637035.

External links[edit]

Contraction Stress Test at webmd.com

UpToDate Contents

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1. 分娩前の胎児心拍数評価 antepartum fetal heart rate assessment
2. 胎児評価の概要 overview of fetal assessment
3. 分娩時胎児心拍数の評価 intrapartum fetal heart rate assessment
4. 胎児機能評価 the fetal biophysical profile
5. 妊娠中の重症筋無力症のマネージメント management of myasthenia gravis in pregnancy

English Journal

Hydration state controls stress responsiveness and social behavior.

Krause EG, de Kloet AD, Flak JN, Smeltzer MD, Solomon MB, Evanson NK, Woods SC, Sakai RR, Herman JP.SourceDepartment of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, Ohio 45219, USA.
The Journal of neuroscience : the official journal of the Society for Neuroscience.J Neurosci.2011 Apr 6;31(14):5470-6.
Life stress frequently occurs within the context of homeostatic challenge, requiring integration of physiological and psychological need into appropriate hormonal, cardiovascular, and behavioral responses. To test neural mechanisms underlying stress integration within the context of homeostatic adve
PMID 21471383

Japanese Journal

high risk妊娠に対するNipple Stimulation Contraction Stress Testの臨床的有用性と安全性の検討 : Oxytocin Challenge Testとの比較

伊原由幸,清水卓,井上欣也,安藤暢哉
日本産科婦人科學會雜誌 41(1), 101-104, 1989-01-01
NAID 110002105422

Related Pictures

OXYTOCIN CHALLENGE TEST Phrase on the Screen. Internistuse Internet 3 pregnancy monitoring PPT - Assessment of Fetal Well-Being PowerPoint Presentation - ID:330673 Oxytocics: Induction and Augmentation of Labor Assessment of fetal wellbeing