The Definition and the Significance of Decreased Fetal Movements

Sadovsky, E.; Ohel, Gonen; Havazeleth, H.; Steinwell, A.; Penchas, S

doi:10.3109/00016348309154211

Cited by 47 publications

(4 citation statements)

References 16 publications

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“…The primary outcome measure was maternal behavior in relation to reporting perceived absence or decreased fetal movement to the health provider; defined as the rate of women waiting ≥25 hours with absent fetal movement or ≥48 hours with DFM [6,16,29,40,41]. …”

Section: Methodsmentioning

confidence: 99%

Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women - a clinical quality improvement

et al. 2010

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BackgroundDelayed maternal reporting of decreased fetal movement (DFM) is associated with adverse pregnancy outcomes. Inconsistent information on fetal activity to women during the antenatal period may result in delayed reporting of DFM. We aimed to evaluate an intervention of implementation of uniform information on fetal activity to women during the antenatal period.MethodsIn a prospective before-and-after study, singleton women presenting DFM in the third trimester across 14 hospitals in Norway were registered. Outcome measures were maternal behavior regarding reporting of DFM, concerns and stillbirth. In addition, cross-sectional studies of all women giving birth were undertaken to assess maternal concerns about fetal activity, and population-based data were obtained from the Medical Birth Registry Norway.ResultsPre- and post-intervention cohorts included 19 407 and 46 143 births with 1 215 and 3 038 women with DFM respectively. Among primiparous women with DFM, a reduction in delayed reporting of DFM (≥48 hrs) OR 0.61 (95% CI 0.47-0.81) and stillbirths OR 0.36 (95% CI 0.19-0.69) was shown in the post-intervention period. No difference was shown in rates of consultations for DFM or maternal concerns. Stillbirth rates and maternal behavior among women who were of non-Western origin, smokers, overweight or >34 years old were unchanged.ConclusionsUniform information on fetal activity provided to pregnant women was associated with a reduction in the number of primiparous women who delayed reporting of DFM and a reduction of the stillbirth rates for primiparous women reporting DFM. The information did not appear to increase maternal concerns or rate of consultation. Due to different imperfections in different clinical settings, further studies in other populations replicating these findings are required.

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Section: Methodsmentioning

confidence: 99%

Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women - a clinical quality improvement

et al. 2010

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“…respondents; this was initially described as a 'movement alarm signal' to identify IUFD and IUGR in 1983 (21). Both these definitions of DFM were developed in high-risk inpatient populations counting all perceived fetal movements throughout the day, making their application to a normal obstetric population counting for a brief period problematic.…”

Section: B001mentioning

confidence: 99%

Midwives’ and obstetricians’ knowledge and management of women presenting with decreased fetal movements

Heazell

Green

Wright

et al. 2008

Acta Obstet Gynecol Scand

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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.

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“…Conversely, maternal perception of changes in activity can indicate fetal compromise; the most commonly reported change is a reduction in fetal movement. 1 2 Maternal perception of reduced fetal movements (RFM) is associated with adverse pregnancy outcomes including fetal growth restriction, 3 oligohydramnios 4 and stillbirth. 3 These conditions are associated with placental dysfunction, which is observed in women with RFM.…”

Section: Introductionmentioning

confidence: 99%

Alterations in maternally perceived fetal movement and their association with late stillbirth: findings from the Midland and North of England stillbirth case–control study

Heazell

Budd

et al. 2018

BMJ Open

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ObjectiveTo report perception of fetal movements in women who experienced a stillbirth compared with controls at a similar gestation with a live birth.DesignCase–control study.Setting41 maternity units in the UK.ParticipantsCases were women who had a late stillbirth ≥28 weeks gestation (n=291) and controls were women with an ongoing pregnancy at the time of the interview (n=733). Controls were frequency matched to cases by obstetric unit and gestational age.MethodsData were collected using an interviewer-administered questionnaire which included questions on maternal perception of fetal movement (frequency, strength, increased and decreased movements and hiccups) in the 2 weeks before the interview/stillbirth. Five fetal movement patterns were identified incorporating the changes in strength and frequency in the last 2 weeks by combining groups of similar pattern and risk. Multivariable analysis adjusted for known confounders.Primary outcome measureAssociation of maternally perceived fetal movements in relation to late stillbirth.ResultsIn multivariable analyses, women who reported increased strength of movements in the last 2 weeks had decreased risk of late stillbirth compared with those whose movements were unchanged (adjusted OR (aOR) 0.18, 95% CI 0.13 to 0.26). Women with decreased frequency (without increase in strength) of fetal movements were at increased risk (aOR 4.51, 95% CI 2.38 to 8.55). Daily perception of fetal hiccups was protective (aOR 0.31, 95% CI 0.17 to 0.56).ConclusionsIncreased strength of fetal movements and fetal hiccups is associated with decreased risk of stillbirth. Alterations in frequency of fetal movements are important in identifying pregnancies at increased risk of stillbirth, with the greatest risk in women noting a reduction in fetal activity. Clinical guidance should be updated to reflect that increase in strength and frequency of fetal movements is associated with the lowest risk of stillbirth, and that decreased fetal movements are associated with stillbirth.Trial registration numberNCT02025530.

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The Definition and the Significance of Decreased Fetal Movements

Cited by 47 publications

References 16 publications

Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women - a clinical quality improvement

Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women - a clinical quality improvement

Midwives’ and obstetricians’ knowledge and management of women presenting with decreased fetal movements

Alterations in maternally perceived fetal movement and their association with late stillbirth: findings from the Midland and North of England stillbirth case–control study

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