If a patient shows no movement on an NST, what is the next best step?

When a patient shows no movement on a non-stress test (NST), it indicates that the fetal heart rate is not responding appropriately to fetal movements, which raises concerns about fetal well-being. The next best step in this scenario is to perform a biophysical profile (BPP). A BPP is a comprehensive assessment that evaluates fetal health by measuring multiple parameters including fetal heart rate, movements, tone, and amniotic fluid volume. This additional information helps to provide a clearer picture of the fetus's condition and can guide further management.

The rationale for choosing a BPP over other options lies in its detailed analysis, which can help in identifying potential issues such as fetal distress or placental insufficiency. This method is especially useful if the NST is non-reactive, as it can continue to monitor the fetus without intrusive procedures and provide critical insights to inform decision-making regarding the timing and mode of delivery if necessary.

While administering glucose can be relevant in cases of maternal hypoglycemia or decreased fetal activity, it doesn't directly address the immediate observation of no fetal movement. Repeating the NST immediately can be helpful in some cases, but it does not provide the comprehensive assessment that a BPP offers. Planning for an elective cesarean delivery might be an endpoint