Reduced Fetal Movements at Term, Low-risk Pregnancies: is It Associated with Adverse Pregnancy Outcomes? Ten Years of Experience from a Single Tertiary Center

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2020 Mar 22

PMID 32198623

Citations 5

Authors

Michal Levy

Michal Kovo

Giulia Barda

Ohad Gluck

Liron Koren

Jacob Bar

Eran Weiner

Affiliations

Soon will be listed here.

Abstract

Objective: We aimed to assess the outcomes of low-risk pregnancies complicated by isolated reduced fetal movements (RFM) at term.

Study Design: The study population were patients at term, with singleton, low-risk, pregnancies who presented to our obstetric-triage and delivered during the subsequent 2 weeks. The study group included patients with an isolated complaint of RFM (RFM group). The control group included patients without history of RFM (control group). The pregnancy, delivery, and neonatal outcomes were compared between the groups. Severe and mild composites of adverse neonatal outcomes were defined. Multivariate regression analyses were performed to identify independent association with adverse neonatal outcomes.

Results: Among the 13,338 pregnant women, 2762 (20.7%) were included in the RFM group and 10,576 (79.3%) in the control group. The RFM group had higher rates of nulliparity (p < 0.001), and smoking (p < 0.001). At admission, the RFM group had higher rates of IUFD (p < 0.001). The RFM group had higher rates of Cesarean delivery due to non-reassuring fetal monitor (p < 0.001), and mild adverse neonatal outcomes (p = 0.001). RFM was associated with mild adverse outcome independent of background confounders (aOR = 1.4, 95% CI 1.2-2.6, p < 0.001).

Conclusion: Patients presented with isolated RFM at term had higher rates of IUFD at presentation and significant adverse outcomes at delivery.

Citing Articles

Prenatal Manifestation of Transient Abnormal Myelopoiesis: Case Report and Review of the Literature.

Walasik I, Litwinska-Korcz E, Szpotanska M, Stanirowski P, Ksiezopolska A, Ludwin A J Clin Med. 2024; 13(16).

PMID: 39200726 PMC: 11354785. DOI: 10.3390/jcm13164584.

Development of a core outcome set (COS) for studies relating to awareness and clinical management of reduced fetal movement: study protocol.

Hayes D, Devane D, Dumville J, Smith V, Walsh T, Heazell A Trials. 2021; 22(1):894.

PMID: 34886899 PMC: 8655489. DOI: 10.1186/s13063-021-05839-9.

Country of birth, educational level and other predictors of seeking care due to decreased fetal movements: an observational study in Sweden using data from a cluster-randomised controlled trial.

Radestad I, Pettersson K, Lindgren H, Skokic V, Akselsson A BMJ Open. 2021; 11(6):e050621.

PMID: 34172554 PMC: 8237734. DOI: 10.1136/bmjopen-2021-050621.

Evaluation of Pregnancy Outcomes Among Women With Decreased Fetal Movements.

Turner J, Flenady V, Ellwood D, Coory M, Kumar S JAMA Netw Open. 2021; 4(4):e215071.

PMID: 33830228 PMC: 8033440. DOI: 10.1001/jamanetworkopen.2021.5071.

Assessing fetal movements in pregnancy: A qualitative evidence synthesis of women's views, perspectives and experiences.

Smith V, Muldoon K, Brady V, Delaney H BMC Pregnancy Childbirth. 2021; 21(1):197.

PMID: 33691666 PMC: 7944914. DOI: 10.1186/s12884-021-03667-y.

References

Froen J . A kick from within--fetal movement counting and the cancelled progress in antenatal care. J Perinat Med. 2004; 32(1):13-24. DOI: 10.1515/JPM.2004.003. View

Mangesi L, Hofmeyr G, Smith V, Smyth R . Fetal movement counting for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2015; (10):CD004909. PMC: 9270931. DOI: 10.1002/14651858.CD004909.pub3. View

Smith C, Davis S, Rayburn W . Patients' acceptance of monitoring fetal movement. A randomized comparison of charting techniques. J Reprod Med. 1992; 37(2):144-6. View

Christensen F, Olson K, Rayburn W . Cross-over trial comparing maternal acceptance of two fetal movement charts. J Matern Fetal Neonatal Med. 2003; 14(2):118-22. DOI: 10.1080/jmf.14.2.118.122. View

Gomez L, de la Vega G, Padilla L, Bautista F, Villar A . Compliance with a fetal movement chart by high-risk obstetric patients in a Peruvian hospital. Am J Perinatol. 2007; 24(2):89-93. DOI: 10.1055/s-2006-958160. View

Sadovsky E, POLISHUK W . Fetal movements in utero: nature, assessment, prognostic value, timing of delivery. Obstet Gynecol. 1977; 50(1):49-55. View

Heazell A, Froen J . Methods of fetal movement counting and the detection of fetal compromise. J Obstet Gynaecol. 2008; 28(2):147-54. DOI: 10.1080/01443610801912618. View

Sadovsky E, Yaffe H . Daily fetal movement recording and fetal prognosis. Obstet Gynecol. 1973; 41(6):845-50. View

Tveit J, Saastad E, Stray-Pedersen B, Bordahl P, Froen J . Maternal characteristics and pregnancy outcomes in women presenting with decreased fetal movements in late pregnancy. Acta Obstet Gynecol Scand. 2009; 88(12):1345-51. DOI: 10.3109/00016340903348375. View

10.

OSullivan O, Stephen G, Martindale E, Heazell A . Predicting poor perinatal outcome in women who present with decreased fetal movements. J Obstet Gynaecol. 2009; 29(8):705-10. DOI: 10.3109/01443610903229598. View

11.

Sinha D, Sharma A, Nallaswamy V, Jayagopal N, Bhatti N . Obstetric outcome in women complaining of reduced fetal movements. J Obstet Gynaecol. 2007; 27(1):41-3. DOI: 10.1080/01443610601016909. View

12.

Tveit J, Saastad E, Stray-Pedersen B, Bordahl P, Froen J . Concerns for decreased foetal movements in uncomplicated pregnancies--increased risk of foetal growth restriction and stillbirth among women being overweight, advanced age or smoking. J Matern Fetal Neonatal Med. 2010; 23(10):1129-35. DOI: 10.3109/14767050903511578. View

13.

Bradford B, Thompson J, Heazell A, McCowan L, McKinlay C . Understanding the associations and significance of fetal movements in overweight or obese pregnant women: a systematic review. Acta Obstet Gynecol Scand. 2017; 97(1):13-24. DOI: 10.1111/aogs.13250. View

14.

Kehl S, Schelkle A, Thomas A, Puhl A, Meqdad K, Tuschy B . Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol. 2015; 47(6):674-9. DOI: 10.1002/uog.14924. View

15.

Dollberg S, Haklai Z, Mimouni F, Gorfein I, Gordon E . Birth weight standards in the live-born population in Israel. Isr Med Assoc J. 2005; 7(5):311-4. View

16.

Whitty J, Garfinkel D, Divon M . Maternal perception of decreased fetal movement as an indication for antepartum testing in a low-risk population. Am J Obstet Gynecol. 1991; 165(4 Pt 1):1084-8. DOI: 10.1016/0002-9378(91)90476-8. View

17.

Bhatia M, Mitsi V, Court L, Thampi P, El-Nasharty M, Hesham S . The outcomes of pregnancies with reduced fetal movements: A retrospective cohort study. Acta Obstet Gynecol Scand. 2019; 98(11):1450-1454. DOI: 10.1111/aogs.13671. View

18.

Heazell A, Sumathi G, Bhatti N . What investigation is appropriate following maternal perception of reduced fetal movements?. J Obstet Gynaecol. 2005; 25(7):648-50. DOI: 10.1080/01443610500278303. View