- Email: [email protected]
False negative oxytocin challenge test
894
Correspondence
159. 1976) reported one fetal death seven clays folio\\ing a negative OCT. In a Letter to the Editors (AM. .J ORSTET. GYNF,COI.. 123: 106. 1975). Dr. Baskett related two additional fetal deaths in utero. preceded six and a half days by negative OCT’s. Dr. Klapholr r-worded the earhest fetal death occurring only six hours atict. ;I negative OCT (J. Reprod. Med. lci: 169. 197.5). Our experience of 255 negative OCT’s in 140 highrisk patients favorably supports previous data. I-IO\\ever, one exception has bern noted.
positive) of accepting the difference of the two rates as being significant. Since the mean values (rates) are used as a guide, we feel quite justified in our conservative approach to minimize both the false positive (Type I) and false negative (Type II) errors. Nevertheless, Mr. Sivin’s conclusion that further investigation might be ot‘ value is well taken. Dnniol R. Mkhrll. Jr,, M.D. ProJbssor and Assaciak Chairman Woman’s Hospital 1240 North illi.uion Road Los Angeles. California 90033
A primigravid patient with an uncomplicated pregnancy at 43 weeks’ gestation by firm dates and third-trimester untrasound examination had initiation of monitoring by OC7”s and triweekly estriol determinations. The first estriol level was IOM normal (12 mg per 24 hours). An
REFERENCES
Hill. A. B.: Principles of Medical Statistics, ed. 8, New York, 1967, Oxford University Press, pp. 121-132. Hines, D. C., and Goldzieher, J. H.: Clinical investigation: A guide to its evaluation, AM. J. OBSTET. GYNECOL. 105: 450, 1969. Roy, S., Azen, S. P., Mishell. D. R., Jr., Pike, M. C., and Casagrande, J.: Experience with the Copper-T and silicone shell loop in parous women: A randomized study, Contraception 13: 365. 1976.
False negative oxytocin challenge test
This case illustrates a negative 0(X followed by- ti,tal death within 14 hours. In contrast. most p?eviously rcported intrauterine deaths occurred near the end of the one-week “safe period.” Despite this tragedy, the negative OCT remains as a remarkable indicator of fetal safety. Hwever, it is still necessary to utilize all available aids and to explore nel\ modes of detecting changes in intrautcrinc fetal status in the high-risk pregnancy. Ronald G. ;\larc~~n. M.D., J.F.A.CL0.G. ?640 ,V. If’. Snmwitar~ Drkv Corvallis, Orqyrr 97330
To the Editon: Recently, the oxytocin challenge test (OCT) has gained increasing prominence in the management of high-risk pregnancies. One distinct advantage is its predictive value of intrauterine fetal well-being. Most authors agree that if a negative OCT is obtained the status of the fetus is relatively secure for one week. Even so, there have been reports of false negative OCT’s. Dr. Freeman (Obstet. Gynecol. 47: 8, 1976) reported two fetal deaths six and seven days after negative OCT’s. and Dr. Farahani (Obstet. Gynecol. 47:
Fig..
1.
Correspondence
159. 1976) reported one fetal death seven clays folio\\ing a negative OCT. In a Letter to the Editors (AM. .J ORSTET. GYNF,COI.. 123: 106. 1975). Dr. Baskett related two additional fetal deaths in utero. preceded six and a half days by negative OCT’s. Dr. Klapholr r-worded the earhest fetal death occurring only six hours atict. ;I negative OCT (J. Reprod. Med. lci: 169. 197.5). Our experience of 255 negative OCT’s in 140 highrisk patients favorably supports previous data. I-IO\\ever, one exception has bern noted.
positive) of accepting the difference of the two rates as being significant. Since the mean values (rates) are used as a guide, we feel quite justified in our conservative approach to minimize both the false positive (Type I) and false negative (Type II) errors. Nevertheless, Mr. Sivin’s conclusion that further investigation might be ot‘ value is well taken. Dnniol R. Mkhrll. Jr,, M.D. ProJbssor and Assaciak Chairman Woman’s Hospital 1240 North illi.uion Road Los Angeles. California 90033
A primigravid patient with an uncomplicated pregnancy at 43 weeks’ gestation by firm dates and third-trimester untrasound examination had initiation of monitoring by OC7”s and triweekly estriol determinations. The first estriol level was IOM normal (12 mg per 24 hours). An
REFERENCES
Hill. A. B.: Principles of Medical Statistics, ed. 8, New York, 1967, Oxford University Press, pp. 121-132. Hines, D. C., and Goldzieher, J. H.: Clinical investigation: A guide to its evaluation, AM. J. OBSTET. GYNECOL. 105: 450, 1969. Roy, S., Azen, S. P., Mishell. D. R., Jr., Pike, M. C., and Casagrande, J.: Experience with the Copper-T and silicone shell loop in parous women: A randomized study, Contraception 13: 365. 1976.
False negative oxytocin challenge test
This case illustrates a negative 0(X followed by- ti,tal death within 14 hours. In contrast. most p?eviously rcported intrauterine deaths occurred near the end of the one-week “safe period.” Despite this tragedy, the negative OCT remains as a remarkable indicator of fetal safety. Hwever, it is still necessary to utilize all available aids and to explore nel\ modes of detecting changes in intrautcrinc fetal status in the high-risk pregnancy. Ronald G. ;\larc~~n. M.D., J.F.A.CL0.G. ?640 ,V. If’. Snmwitar~ Drkv Corvallis, Orqyrr 97330
To the Editon: Recently, the oxytocin challenge test (OCT) has gained increasing prominence in the management of high-risk pregnancies. One distinct advantage is its predictive value of intrauterine fetal well-being. Most authors agree that if a negative OCT is obtained the status of the fetus is relatively secure for one week. Even so, there have been reports of false negative OCT’s. Dr. Freeman (Obstet. Gynecol. 47: 8, 1976) reported two fetal deaths six and seven days after negative OCT’s. and Dr. Farahani (Obstet. Gynecol. 47:
Fig..
1.