Interventions to enhance maternal awareness of decreased fetal movement: a systematic review

Abstract

Background Decreased fetal movement is associated with adverse pregnancy and birth outcomes; timely reporting and appropriate management may prevent stillbirth.Objectives Determine effects of interventions to enhance maternal awareness of decreased fetal movement.Search strategy Cinahl, The Cochrane Library, EMBASE, MEDLINE, PsycINFO and SCOPUS databases; without limitation on language or publication year.Selection criteria Randomised or non-randomised studies evaluating interventions to enhance maternal awareness of decreased fetal movement.Data collection and analysis Two authors independently extracted data and assessed quality.Main results We included 23 publications from 16 studies of fair to poor quality. We were unable to pool results due to substantial heterogeneity between studies. Three randomised controlled trials (RCTs) and five non-randomised studies (NRSs), involving 72 888 and 115 435 pregnancies, respectively, assessed effects of interventions on stillbirth and perinatal death. One large cluster RCT (n = 68 654) reported no stillbirth reduction, one RCT (n = 3111) reported significant stillbirth reduction, and one RCT (n = 1123) was small with no deaths. All NRSs favoured intervention over standard care; three studies (n = 31 131) reported significant reduction, whereas two studies (n = 84 304) reported non-significant reductions in stillbirth or perinatal deaths. Promising results from NRSs warrant further research. We found no evidence of increased maternal concern following interventions. No cost-effectiveness data were available.Conclusions We found no clear evidence of benefit or harm; indirect evidence suggests improved pregnancy and birth outcomes. The optimal approach to support women in monitoring their pregnancies needs to be established. Meanwhile, women need to be informed about the importance of fetal movement for fetal health.Keywords Awareness, decreased fetal movement, fetal movement counting, maternal concern, maternal-fetal attachment, stillbirth.Tweetable abstract The benefits and risks of interventions to increase pregnant women's awareness of fetal movement are unclear.

Preventing deaths due to the hypertensive disorders of pregnancy

“…Winje and colleagues have performed a systematic review of randomised and NRSs assessing the effects of interventions to enhance maternal awareness of decreased foetal movement [85]. Results were not pooled due to substantial heterogeneity between studies.…”

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

“…It reduces the risk of stillbirth, fetal growth restriction, fetal distress and perinatal mortality. Furthermore, the maternal-fetal attachment is increased by fetal movements' perception (11,20,21) . Health care providers have long acknowledged the importance of maternally perceived fetal movements, but continue to DOI: 10.9790/1959-060207107119 www.iosrjournals.org 117 | Page under investigate the maternal perception of fetal activity to date (22,23) .…”

Auditing stillbirths at Lower Umfolozi War Memorial Regional Hospital: A 12-month review

“…A systematic review of interventions to improve maternal awareness of decreased fetal movement, based on 16 studies from developed countries, did not provide clear evidence of benefit or harm; however, indirect evidence suggested improved pregnancy and birth outcomes. [16] Olabuji et al [17] demonstrated that maternal education level was a significant factor in the perception of abnormal fetal movements in their sample of Nigerian women during the third trimester of pregnancy. However, 41% of the women indicated they would only seek help after 24 hours of absent fetal movements.…”