Fetal Activity in Pregnancies Complicated by Maternal Diabetes Mellitus

Abstract

Summary The incidence of fetal breathing movements (FBM), fetal trunk movements (FTM), and total fetal activity (TFA) was assessed in 25 pregnancies complicated by maternal diabetes mellitus; 20 mothers had been juvenile insulin dependent diabetics, 4 were diagnosed during pregnancy (one of whom required insulin) and there was one other who was changed from chlorpropamide to insulin during the first trimester of pregnancy. Thirty‐minute records were made postprandial between 32 and 38 weeks making a total of 161 recordings. There were 15 well‐controlled insulin‐dependent diabetic women with uncomplicated pregnancies; and in this group the mean percentage incidence of FBM was 60±25 (SD) per cent, FTM 16±10 (SD) per cent and TFA 73±22 (SD) per cent. The mean breathing rate per minute was 53±12 and the mean number of movements per 30‐minute period 29±18. The incidences of FBM and TFA were significantly higher than those found in postprandial recordings in normal pregnancies. There was only one recording out of 115 where the incidence of TFA fell below 10 per cent. The mean percentage incidences of FBM, FTM and TFA were similar in the four uncomplicated pregnancies in which diabetes was diagnosed during pregnancy. The mean percentage incidence of TFA was significantly lower in the six pregnancies with obstetric complications, and levels of TFA below 10 per cent correlated well with abnormal cardiotocograph traces or fetal distress in labour.

Antepartum Fetal Surveillance and Timing of Delivery in the Pregnancy Complicated by Diabetes Mellitus

“…Studies have noted that fetal limb, body, and breathing movements correlate with maternal glucose concentrations with an increase in activity reported being associated with a higher blood glucose level. 22 Maternal perception of 10 movements in a 2-hour period is generally considered reassuring. A decrease in fetal activity should be evaluated by fetal nonstress testing or biophysical profile (BPP).…”

Prediction of fetal acidaemia in pregnancies complicated by maternal diabetes mellitus by biophysical profile scoring and fetal heart rate monitoring

“…In uteroplacental insufficiency fetal nutrition and oxygenation are impaired, leading to growth retardation and acidaemia with hypoxaemia which are accompanied by reduced fetal breathing and urine production (Ribbert et al 1990). In contrast, in diabetic pregnancies fetal acidaemia is associated with maternal hyperglycaemia, and both the amniotic fluid volume and fetal breathing movements are either normal or increased (Roberts et al 1980; Lunell 1986). In this respect, normal fetal breathing and amniotic fluid volume may provide false reassurance of fetal wellbeing, not only in uncomplicated diabetic pregnancies at term but also in diabetic pregnancies with the added complication of placental insufficiency.…”

Antepartum Fetal Surveillance and Timing of Delivery in The Pregnancy Complicated by Diabetes Mellitus

“…However, this study has not been duplicated in other populations. 22 Maternal perception of 10 movements in a 2-hour period is generally considered reassuring. 20 Fetal movement counts or fetal kick counts are an accessible, inexpensive way to evaluate fetal well-being in the third trimester.…”