Maternal understanding of fetal movement in third trimester: A means for fetal monitoring and reducing stillbirth

Olagbuji, Biodun Nelson; Igbarumah, S; Akintayo, Akinyemi A.; Olofinbiyi, BA; Aduloju, PO; Alao, OO

doi:10.4103/1119-3077.134049

Cited by 24 publications

(25 citation statements)

References 21 publications

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“…One possible explanation is that women may be picking up the underlying message from society that technology is better at assessing their baby's well-being than they are which may decrease women's confidence in their own knowledge and ability to assess fetal condition. The result of Olagbuji et al, (2014) (32) , confirm the present study results.…”

Section: Discussionsupporting

confidence: 83%

“…It seems that the variation in the results could be due to the differences in the type of sampling and scoring system used. Our findings on sources of information about fetal movement are consistent with those of Berndl et al, (2013) (24) Raynes -Greenow et al, (2013) (28) , and Olagbuji et al, (2014) (32) , which showed that doctors and nurses are the leading sources of information to women about fetal movement . While, the result was inconsistent with Maputle and Mothiba (2006) (23) , who indicated that a significant number of mothers (54 %) received information about fetal movement from mothers / significant others which could be inaccurate.…”

Section: Discussionsupporting

confidence: 82%

“…A considerable proportion of the surveyed women had no clue of the expected normal frequency of fetal movement despite the fact that any alteration in regular fetal activity in the last trimester of pregnancy may be a signal for impending stillbirth. The obtained result is consistent with Maputle and Mothiba (2006) (23) , and Olagbuji et al,(2014) (32) . The deeply divided evidence on the frequency of fetal movements in the last trimester of pregnancy account for this consistency (27,33) .…”

Section: Discussionsupporting

confidence: 82%

“…Moreover, only 7.7 % received information about the form of fetal movement. This result disagrees with the studies of RaynesGreenow et al, (2013) (28) , Olagbuji et al, (2014) (32) , and Peat et al, (2012) (36) . Meanwhile, the Australian and New Zealand Stillbirth Alliance (ANZSA) published guidelines regarding fetal movements, which were consistent with the Royal College of Obstetricians and Gynaecologists' guidelines in the United Kingdom (37,27) .…”

Section: Discussioncontrasting

confidence: 57%

See 3 more Smart Citations

Maternal Perception and Antenatal Advice regarding Fetal Movements in Al-Gharbyia Governorate, Egypt

Belal¹,

Elkazeh²

2017

IOSR JNHS

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 57%

See 2 more Smart Citations

Maternal Perception and Antenatal Advice regarding Fetal Movements in Al-Gharbyia Governorate, Egypt

Belal¹,

Elkazeh²

2017

IOSR JNHS

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“…Studies have shown that about 40% women would seek medical help only after perceiving no movements for 24 hours. 9 Hence it is important to advice that urgent medical help is needed for RFM, and not after a long time nor until they feel no movements.…”

Section: Discussionmentioning

confidence: 99%

Obstetric and neonatal outcome among women presenting with reduced fetal movements in third trimester

Poojari

Kumar

Vasudeva

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONMaternal perception of fetal movements is a selfscreening method for assessing fetal well-being. Studies have shown that reduced fetal movement (RFM) is a risk factor for several adverse perinatal outcomes. About a quarter of women presenting with RFM have pregnancies complicated by fetal growth restriction, preterm delivery, fetal distress or stillbirth. A growing number of studies have confirmed a correlation between episodes of RFM and stillbirth.1 RFM has been shown to occur in up to 15% of pregnancies.2 Women who have a stillbirth note a reduction in fetal movement prior to diagnosis in up to 55%.3 Inadequate clinician response to the complaint of RFM is an important contributory factor to stillbirth. 4 Fetal movement counting may allow the clinician to make appropriate interventions in right time to improve ABSTRACT Background: Reduced maternal perception of fetal movements allows early identification, timely evaluation and intervention for fetuses at risk of adverse outcome. The primary objective of this study was to assess the pregnancy characteristics and outcomes of pregnant women presenting to hospital with reduced fetal movements (RFM). Methods: Prospective observational study, recruiting all women with singleton pregnancy at or beyond 28 weeks of gestation presenting with a subjective perception of RFM from April 2015 to December 2016. Maternal characteristics, antenatal risk factors, management pathways and perinatal outcome studied. Results: 47% belonged to high risk pregnancy. Among high risk women, although only 39% showed poor BPP at the first presentation, 58% were delivered irrespective of their gestational age, out of which 32.75% had poor neonatal outcome. Among low risk who had >2 episodes of RFM, 50% had poor neonatal outcome. 7% among high risk pregnancies and 18% among low risk, presented with RFM within 48 hours following steroid prophylaxis.24% of high risk women showed liquor volume abnormalities as compared to low risk (6.3%). Conclusions: Significant proportion of those with RFM belonged to high risk pregnancy. Among high risk group, there were high rates of stillbirth and poor BPP at the time of admission when compared to low risk group. Due to early approach to the hospital and timely intervention, significant women with abnormal BPP had good perinatal outcome. All those fetuses who were delivered on first episode of RFM in low risk group did not show evidence of compromise at birth, probably indicating unnecessary delivery. More than 2 episodes of RFM even among low risk group seems significant as good number of fetuses were compromised at birth. Steroids prophylaxis for the fetal lung maturity causes transient changes in BPP, hence unnecessary delivery should be avoided especially those among low risk pregnancy.

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Excessive fetal movements are a sign of fetal compromise which merits further examination

et al. 2018

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Changes in fetal movement are associated with increased risk of stillbirth after 28 weeks of pregnancy. The majority of studies have focussed on maternal perception of reduced fetal movements, which is associated with stillbirth via placental dysfunction. Recent studies have also described an association between a single episode of excessive fetal movements and late stillbirth. We present a hypothesis that a sudden episode of excessive fetal activity indicates fetal compromise relating to underlying disturbance of the in utero environment, which if it persists can lead to fetal death. The origin of the excessive fetal movements is unknown; they may represent fetal seizures induced by asphyxia or infection, an attempt to release cord entanglement or a change in fetal behaviour (inducing signs of distress) in response to a noxious stimulus. It is also possible that an increase in maternal anxiety may lead to increased perception of fetal activity. Current evidence regarding excessive fetal movements is sparse; there is no clinical guidance regarding how reporting of this symptom might relate to a fetus at risk and which management might reduce the risk of subsequent stillbirth. This could be addressed by prospective observational studies of mothers presenting with excessive fetal movements which could both explore the underlying pathophysiology and determine which investigations could identify fetal compromise in this population. The presence of fetal seizures or umbilical cord entanglement could be evaluated at the time of presentation by cardiotocography and ultrasonography of the fetus and cord. Exposure to infection or noxious stimuli could be evaluated by maternal history and measurement of maternal blood for inflammatory markers or toxins. Maternal anxiety could be assessed by validated anxiety scores. Fetal outcome following excessive fetal movements can be recorded after birth. In addition, the presence of perinatal asphyxia can be assessed using Apgar scores, assessment of fetal acidaemia or measurement of stress-related factors in umbilical cord blood. The placenta and cord can be systematically examined for signs of hypoxia, infection or umbilical cord compression. Such studies would provide evidence regarding the underlying cause of excessive fetal movement and how this symptom might relate to in utero compromise and stillbirth. Ultimately, this approach will determine whether excessive fetal movements can be used alongside reduced fetal movements as a tool to reduce the perinatal mortality rate.

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Maternal understanding of fetal movement in third trimester: A means for fetal monitoring and reducing stillbirth

Cited by 24 publications

References 21 publications

Maternal Perception and Antenatal Advice regarding Fetal Movements in Al-Gharbyia Governorate, Egypt

Maternal Perception and Antenatal Advice regarding Fetal Movements in Al-Gharbyia Governorate, Egypt

Obstetric and neonatal outcome among women presenting with reduced fetal movements in third trimester

Excessive fetal movements are a sign of fetal compromise which merits further examination

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