This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
Non stess test (NST) done on a 36 week pregnant diabetic female is found to be non reactive. What should be done next? 
Select and explain. 
A. Induction of labour, B. LSCS, C. Do NST after 1hr, D. Proceed to biophysical profile
D: Proceed to biophysical profile
Answer: D: Proceed to biophysical profile 
Explanation: Nonreactive NST refers to absence of any fetal activity. Since the NST of this patient is non reactive, the most appropriate next step would be to do a Biophysical profile (BPP). Common indications for BPP are during conditions with significant risk of fetal hypoxia, or as a followup testing for a nonreactive NST. The most common indications for BPP are: Suspected IUGR Preganancy more than 40 weeks Insulin dependent diabetes Hypeension Oligohydramnios Multiple gestation Preterm rupture of membranes Non stress test is based on the principle that well oxygenated fetus responds to spontaneous or induced movement with fetal hea accelerations. NST is considered to be reactive when there are two or more accelerations of more than 15 beats per minute above the baseline and longer than 15 seconds in duration are present in a 20minutes observation.