Document Type : Original Article
Authors
1 College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
2 Obstetrics and Gynecology Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
3 Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
Abstract
BACKGROUND: A non‑stress test (NST) is an essential diagnostic test performed during pregnancy
to assess fetal well‑being. It is a recording of fetal movements besides fetal heart rate, indicating fetal
biophysiological well‑being. As maternal physiology is altered in various positions, apt positioning
during the NST is essential for accurate results while ensuring maternal comfort. This study aims to
evaluate the effect of different maternal positions, left lateral and semi‑fowler’s, on NST reactivity,
maternal blood pressure, heart rate, and comfort in pregnant women while performing the NST.
MATERIALS AND METHODS: This crossover study evaluated 50 healthy pregnant women between
32 and 40 weeks of gestation with no obstetric complications for the effect of maternal positions
on maternofetal physiological parameters and comfort. The NST was performed for 20 min in each
position with a washout period of 10 min. The maternofetal physiological parameters were recorded
by a calibrated sphygmomanometer and the electrocardiograph interpretations. The maternal comfort
was assessed using a maternal comfort rating scale (MCRS) for each position after the NST. Relevant
descriptive and inferential statistics are applied to compute the results.
RESULTS: Statistically, there was a significant difference in the mean maternal blood pressure and
heart rate between the left lateral and semi‑fowler’s positions at 0 and 20 min (P = 0.001), whereas
within the groups, in the same position at 0 and 20 min, no significant difference was found. There
was no significant difference in NST reactivity (P = 0.79) in different positions. There was no significant
difference between the MCR scores of women in either of the positions (Z = −1.64, df = 49, P = 0.100).
CONCLUSION: Semi‑fowler’s position demonstrated favorable maternal blood pressure and heart
rate during the NST in the third trimester of pregnancy, though it was clinically not significant. There
was no significant difference in the comfort of women in both positions. Hence, either of the positions
can be implemented in practice as an alternative position while performing the NST, based on the
women’s preference.
Keywords
pregnancy experience. Available from: https://www.who.
int/publications/i/item/9789241549912. [Last accessed on
2021 Oct 27].
2. The State of the World’s Children 2019 Statistical Tables-UNICEF
Data. Available from: https://data.unicef.org/resources/
dataset/sowc-2019-statistical-tables/. [Last accessed on
2021 Oct 27].
3. Kiratli D, Yavan T, Karaşahin KE, Yenen MC. The effect of
different maternal positions on reactivity of the nonstress test,
maternal blood pressure and heart rate. İzmir Dr. Behçet Uz
Çocuk Hastanesi Dergisi 2018;8:101-8.
4. Pirhadi M, Valiani M. Assessing effects of BL67 points stimulation
on fetal heart rate parameters and fetal movements during
nonstress test. J Educ Health Promot 2017;6:43.
5. Chapman L, Durham RF. Maternal-Newborn Nursing: The
Critical Components of Nursing Care. In: FD: F. A. Davis
Company; 2010. p. 177–83.
6. Umana OD, Siccardi MA. Prenatal Non-stress Test. In: StatPearls.
Treasure Island (FL): StatPearls Publishing; 2022.
7. Stone PR, Burgess W, McIntyre JP, Gunn AJ, Lear CA, Bennet L,
et al. Effect of maternal position on fetal behavioural state and heart rate variability in healthy late gestation pregnancy. J Physiol
2017;595:1213-21.
8. Aluş M, Okumuş H, Mete S, Güçlü S. The effects of different
maternal positions on non-stress test: An experimental study.
J Clin Nurs 2007;16:562-8.
9. Sekhavat L, Tabatabaei A. The effect of different maternal position
on non-stress test (NST). World Appl Sci J 2014;32:838-56.
10. Lohana RU, Khatri M, Hariharan C. Correlation of non stress test
with fetal outcome in term pregnancy (37-42 Weeks). Int J Reprod
Contracept Obstet Gynecol 2013;24:639-46.
11. Brown R, Patrick J. The nonstress test: How long is enough? Am
J Obstet Gynecol 1981;141:646-51.
12. Moffatt FW, Van den Hof M. Semi-Fowler’s positioning, lateral
tilts, and their effects on nonstress tests. J Obstet Gynecol Neonatal
Nurs 1997;26:551-7.
13. EL Sayed H, Mohamady S. Effects of different maternal positions
during non-stress test on maternofetal physiological parameters.
Tanta Sci Nurs J 2016;10:116-31.
14. Cito G, Luisi S, Mezzesimi A, Cavicchioli C, Calonaci G,
Petraglia F. Maternal position during non-stress test and fetal
heart rate patterns. Acta Obstet Gynecol Scand 2005;84:335-8.
15. Himabindu P, Sundari MT, Pavani S. Evaluation of non-stress
test in monitoring high risk pregnancies. J Dent Med Sci
2015;14:40-2.
16. Nathan EB, Haberman S, Burgess T, Minkoff H. The relationship
of maternal position to the results of brief nonstress tests:
A randomized clinical trial. Am J Obstet Gynecol 2000;182:1070-2.
17. Ibrahim HA, ElgzarWT, Saied EA. The effect of different positions
during non-stress test on maternal hemodynamic parameters,
satisfaction, and fetal cardiotocographic patterns. Afr J Reprod
Health 2021;25:81-9.
18. McKinney SM. Foundations of Maternal-Newborn and Women’s
Health Nursing. 6th ed. Saunders; 2013. p. 235–6.
19. Tamás P, Szilágyi A, Jeges S, Vizer M, Csermely T, Ifi Z, et al.
Effects of maternal central hemodynamics on fetal heart rate
patterns. Acta Obstet Gynecol Scand 2007;86:711-4.
20. Mucuk S, Bülbül T. Effects of position on non-stress test results
and maternal satisfaction. Adv Clin Exp Med 2021;30:1127-32.
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