The fetal activity acceleration determination (FAD) test is a type of NST that evaluates both acceleration of FHR and fetal movement. It can be performed in a hospital, a clinic, practitioners’ office, or possibly a home care setting.
Assess maternal vital signs, last oral intake (including medicines or street drugs), smoking history, and fetal movement history.
Apply external fetal monitor with the woman positioned off her back in lateral tilt position.
Give the woman a button to push when fetal movement occurs; pushing the button causes a mark to appear on the monitor strip.
A nonreactive FAD test (positive result) is ascertained in the same manner as is the NST. Results are of questionable validity before 30 weeks’ gestation. Follow-up for a nonreactive test should include an ultrasound study to assess fetal movement and tone.
A nonreactive FAD test (positive result) is associated with greater risk for fetal hypoxia.
Clinical Alert
Fetal movement tends to decrease as gestation progresses
Pretest Patient Care
Explain reason for testing and FHR monitoring.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed.
Explain need for possible follow-up ultrasound.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.
Normal
Negative result: reactive test
Criteria are similar to those for NST, but fetal movement is also required: more than three discrete body or limb movements within 30 minutes. In a reactive test (well-oxygenated fetus), spontaneous accelerations of FHR begin at about the time of onset of fetal movement. This effect expresses the condition of the neurologic system and its effect on fetal movement and FHR.