Document Detail


Midwives' and obstetricians' knowledge and management of women presenting with decreased fetal movements.
MedLine Citation:
PMID:  18307074     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Maternal perception of decreased fetal movements (DFM) affects 5-15% of pregnancies. DFM is associated with intra-uterine fetal death (IUFD) and intra-uterine growth restriction (IUGR). It has been proposed that maternal perception of DFM may be used as a screening tool for IUFD or IUGR. However, this proposal is complicated by variations in definitions and management of DFM. HYPOTHESIS: We hypothesised that uncertainties in the definition and management of women presenting with DFM leads to variation in clinical practice. METHODS: A postal questionnaire was sent to midwives and consultant obstetricians in the UK. RESULTS: The majority of respondents enquired about the presence of fetal movements after 28 weeks gestation. There was little agreement on a definition of DFM, with a maternal perception of decreased movements for 24 h gaining the greatest acceptance. Few practitioners used formal fetal movement counting, with the majority of respondents stating they were ineffective in the prevention of IUGR or IUFD and led to increased intervention. There was large variation in the knowledge of associations with DFM and management of women presenting with DFM. CONCLUSIONS: There were wide variations in the practice of obstetricians and midwives with regard to women presenting with DFM; many aspects of practice were not based on the available evidence. The variation in practice may result from a lack of robust evidence on which to base the provision of care. Further research is needed to provide and disseminate evidence to direct the management of women presenting with DFM.
Authors:
Alexander E P Heazell; Matthew Green; Caroline Wright; Vicki Flenady; J Frederik Frøen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  87     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  331-9     Citation Subset:  IM    
Affiliation:
Maternal and Fetal Health Research Group, University of Manchester, Manchester, UK. alex_heazell@talk21.com
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Death / diagnosis
Fetal Growth Retardation / diagnosis
Fetal Monitoring / methods*,  standards
Fetal Movement / physiology*
Health Knowledge, Attitudes, Practice*
Humans
Midwifery*
Physicians*
Pregnancy
Pregnancy Complications / physiopathology*

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


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