A 27-year-old primigravida with insulin-dependent diabetes at 34 weeks' gestation had a reactive nonstress test. What does this indicate?

• A. There is evidence of fetal well-being.
• B. There is fetal distress.
• C. The placenta is previa.
• D. There is oligohydramnios.

Answer: (A)

A reactive nonstress test shows fetal well-being. When the fetal heart rate accelerates in response to fetal movement and occurs at least a couple of times within a 20-minute window, it indicates the fetus is receiving adequate oxygen and has a functioning autonomic nervous system. In a 34-week gestation with diabetes, this finding is reassuring because it suggests there isn’t current fetal hypoxia or distress.

The other possibilities don’t fit because placenta previa is a placental location issue diagnosed by ultrasound, not by NST results; oligohydramnios refers to low amniotic fluid volume, also determined by ultrasound, not NST readouts; fetal distress would more likely present as a nonreactive NST with decelerations, not a reactive one.