Decreased fetal movements: background, assessment, and clinical management

Abstract

A reduction or cessation of fetal movements (FMs) is frequently reported by pregnant women and causes concern and anxiety. However, the clinical significance of a history of reduced FMs remains unclear, and the assessment and management of these pregnancies is controversial. This article is a review of the literature on decreased FMs found in medline and the cochrane library using the search phrases: decreased FMs, perinatal outcome, FM monitoring, and fetal assessment. Formal counting of FMs by the pregnant woman could possibly identify the fetuses, which are at risk of compromise, thus allowing for appropriate action. However, the benefit of this intervention has not been definitely proven. Cardiotocography, umbilical/uterine artery Doppler velocimetry, and ultrasonography have been used for antepartum fetal assessment in pregnancies with decreased FMs, but the evidence of a clinical benefit is limited. The effects of fetal assessment with vibroacoustic stimulation and biophysical profile are unknown and should be further evaluated. Present recommendations on the management of pregnancies with decreased FMs are based on limited and inconsistent scientific evidence. There is a need for further well-designed studies in order to provide evidence-based guidelines in the future.

Diagnostic Value of Non Stress Test in Latent Phase of Labor and Maternal and Fetal Outcomes

“…NST is one of the surveillance techniques that can avoid unnecessary interventions in childbirth and associated complications for both mother and fetus. Guidelines for NST, ultrasound examination and Doppler examinations are based on limited evidence (Tveit, Saastad, Stray-Pedersen, Børdahl, Flenady, Fretts, & Frøen, 2009; Olesen, & Svare, 2004; Frøen, Tveit, Saastad, Børdahl, Stray-Pedersen, & Heazell, 2008). Therefore, in order to show the diagnostic value of NST during the latent phase of the labor and its role in diagnosis of fetal complications, this study performed to test the association between NST results and maternal and neonatal outcomes in term pregnant women referred to Alzahra hospital of Tabriz in 2013.…”

Fetal Movement Counting Improved Identification of Fetal Growth Restriction and Perinatal Outcomes – a Multi-Centre, Randomized, Controlled Trial

“…Maternal perception of a gradual diminishment of fetal activity is a significant marker of a vulnerable fetus and can indicate chronic fetal compromise [1]–[5], precede fetal growth restriction, stillbirth, preterm birth and emergency Caesarean section [6]–[8]. The most important marker of decreased fetal activity is what women perceive as decreasing fetal movements [2], [9].…”

Time-frequency characterization of tri-axial accelerometer data for fetal movement detection

“…In fact, fetal movement is capable of identifying antenatal factors that account for over 60% of neurodevelopment problems recognized in childhood as reported in [6]. In particular, decreases in fetal movement have been linked to fetal distress and placental dysfunction [7]. Abnormal fetal movement has also been linked to fetuses with chromosome abnormalities, anencephaly, prolonged oligohydramnios and cerebral malformations [8][9][10].…”