How to Read a Non-Stress Test Graph

Nursing Knowledge

How to Read a Non-Stress Test Graph

A non-stress test in pregnancy assesses a fetal heart rate in response to fetal movements. In a healthy fetus, the heart rate is expected to increase with movement. The fetus may not respond sufficiently if there are issues with oxygenation. Keep reading below for how to interpret the test results and determine if a result is reactive or non-reactive.
Last updated: May 2, 2024

Table of contents

What is a non-stress test in pregnancy? 

A fetal non-stress test is a noninvasive assessment method used as an indication of fetal oxygenation and confirmation of fetal wellbeing. It determines the fetal heart rate response to its own movement. 

When is a fetal non-stress test performed? 

Non-stress tests are done during the 3rd trimester. They may be ordered in response to a noted complication or problem, or in higher-risk pregnancies in mothers over 35 or with chronic conditions. 

Steps of the procedure

  1. A fetal heart rate monitor and tocometer are applied to the abdomen to track the fetal heart rate and contractions, if applicable. 
  2. The fetal heart rate is monitored for at least 20 minutes. 
  3. The results are interpreted and classified as reactive or non-reactive. 
  4. Based on the result, further tests like a biophysical profile or contraction stress test might be indicated. 

Non-stress test interpretation: how to read a non-stress test graph

The interpretation of a non-stress test is done by looking at the fetal heart rate. The test result can be classified as reactive or non-reactive. The expectation is that a fetal heart rate responds to the fetus moving. 

Reactive non-stress test

A reactive non-stress test is the reassuring outcome: The fetus should be able to react. It is defined as two or more fetal heart rate accelerations reaching a peak of at least 15/min above the baseline rate; lasting at least 15 seconds from onset to return to baseline, in a 20-minute period. 

In the example below, you can see a reactive non-stress test result:

  1. The baseline heart rate is within normal range (about 125 here).
  2. The variability is moderate. 
  3. Look for accelerations within the 10-minute period that are 15 beats above the baseline for at least 15 seconds. A reactive test needs 2; this strip shows even more (see circles, aligning with the circles at the bottom of the graph indicating fetal movement). 
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Non-reactive non-stress test

A non-stress test is non-reactive if it does not meet acceleration criteria for a reactive non-stress test. 

The fetal heart rate should be monitored for at least 40 minutes before interpreting the test as non-reactive, since sleep cycles or other factors may cause the fetus to be inactive for a while without it being reason for concern. 


How to Read a Non-Stress Test Graph

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