Four "pseudo neurologic" tests for acute hypoxia and one test for chronic hypoxia (amniotic fluid index). Normal score 8-10. Abnormal results only assigned after a minimum 30min observation time.

    Amniotic fluid: at least one pocket of fluid 2cm deep (2pts). No pockets(0pts). assess chronic hypoxia
   
    Fetal breathing: at least one episode of breathing motion lasting at least 30sec (2pts). No breathing or lasting less than 30 sec (0pts). Most sensitive, as stops with any distress; but also stops with sleeping, therefore if not seen reasses q30 X4 before assigning (0pts)
    Fetal movement: at least 3 discrete body movements of limbs or trunk (2pts). No movements (0pts) 2nd most sensitive test.
    Fetal tone: at least one episode of limb extension from flexed position with return to flexed position (2pts). No extension, or sluggish, with failure to return (0pts) 3rd most sensitive test.
  
     Nonstress Test: 30 min observation of awake fetus while moving should have normal(=reactive) stress test with 2 or more fetal heart rate accelerations of at least 10-15bpm of >30sec duration with 2-4consecutive movements(2pts) Any rate or number increase less than this is nonreactive (0pts)

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