Document Detail


Methods of fetal movement counting and the detection of fetal compromise.
MedLine Citation:
PMID:  18393008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Maternal perception of fetal movements is widely used as a marker of fetal viability and well-being. A reduction in fetal movements is associated with fetal hypoxia, increased incidence of stillbirth and fetal growth restriction (FGR). Therefore, a reduction in fetal movements has been proposed as a screening tool for FGR or fetal compromise. The problem of this approach is that there is no widely accepted definition of reduced fetal activity or 'alarm limits', and pregnant women are currently given a wide range of non-evidence-based advice. We have reviewed the background of published definitions and their potential usefulness in screening. A formal meta-analysis of these studies is not possible due to variation in methodology and definitions of reduced fetal movements. Assessment of fetal movements using formal fetal movement counting has shown equivocal results. Importantly, in all studies, there was a decrease in perinatal mortality suggesting a beneficial role for raising maternal awareness of fetal movements. Most studies implemented limits to define reduced fetal movements based on small groups of high risk pregnancies and obsolete counting methodology. A single case-control study developed 'normal limits' in a low risk population, and successfully implemented it prospectively for screening. At present, there is no evidence that any absolute definition of reduced fetal movements is of greater value than maternal subjective perception of reduced fetal movements in the detection of intrauterine fetal death or fetal compromise. Further investigation is required to determine an effective method of identifying patients with reduced fetal movements and to determine the best subsequent management.
Authors:
A E P Heazell; J F Frøen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology     Volume:  28     ISSN:  1364-6893     ISO Abbreviation:  J Obstet Gynaecol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309140     Medline TA:  J Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  147-54     Citation Subset:  IM    
Affiliation:
Division of Human Development, Maternal and Fetal Health Research Centre, St Mary's Hospital, University of Manchester, UK.
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Distress / diagnosis*
Fetal Growth Retardation / diagnosis*
Fetal Monitoring / methods*
Fetal Movement*
Fetal Viability*
Humans
Pregnancy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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