The Outcome of Mothers Presenting with Reduced Fetal Movements in the Third Trimester of Pregnancy

Main Article Content

Farnaz Sahhaf
Khadijeh Eslamnezhad Namin

Keywords

Fetal movements, neonatal outcomes, Correlational study, maternal knowledge, stillbirth

Abstract

Introduction: There are different ways to evaluate the condition of the fetus during pregnancy. Counting fetal movements is the only way that the mother can use to check the health of the fetus without the need for a doctor and equipment. Fetal movements normally vary between 4 and 122 movements per hour. Awareness of fetal movements can aid in preventing stillbirths.
Materials and Methods: In this study, the term "reduction of fetal movement" referred to cases where pregnant mothers felt less than 12 fetal movements in two hours while at rest and focused on counting. The sample of this study was collected from pregnant women who reported reduced fetal movements and were referred to Al-Zahra Hospital in Tabriz between December 2022 to December 2023.
Results: In this study, 881 pregnant women between the ages of 18 and 42, with a mean age of 26.65, were included. The average age of these women was 26.61 years. In this study, 99.1% of the participants had a normal non-stress test (NST), and 92.8% had a normal biophysical profile (BPP). However, there were eight cases where the BPP results were not reported. Oligohydramnios was present in 10.6% of the patients. 19.7% of the mothers underwent a cesarean delivery. 6.3% of the neonates were admitted to the neonatal intensive care unit (NICU) following birth. Only one case of stillbirth occurred. We have discovered a correlation between a lower amniotic fluid index (AFI) and a lower BPP. There was a correlation between lower BPP scores and lower Apgar scores at the first and fifth minutes after birth. Lower AFI was found to be correlated with a lower pH in the placental artery.
Conclusions: According to our results, it can be concluded that a mother's complaint of reduced fetal movement can be a valuable test to determine the health status of the fetus.

Abstract 188 | PDF Downloads 147

References

1. Plagemann A, Roepke K, Harder T, Brunn M, Harder A, Wittrock-Staar M, et al. Epigenetic malprogramming of the insulin receptor promoter due to developmental overfeeding. 2010.
2. Neldam S. Fetal movements as an indicator of fetal wellbeing. The Lancet. 1980;315(8180):1222-4.
3. Valentin L, Löfgren O, Mars˘ ál K, Gullberg B. Subjective Recording of Fetal Movements: I. Limits and acceptability in normal pregnancies. Acta obstetricia et gynecologica Scandinavica. 1984;63(3):223-8.
4. Zareh F, Eftekhari N. The relationship between maternal perception of decreased fetal movements and rate of fetal complications during delivery. SSU_Journals. 2005;13(1):52-6.
5. Flenady V, MacPHAIL J, Gardener G, Chadha Y, Mahomed K, Heazell A, et al. Detection and management of decreased fetal movements in Australia and New Zealand: a survey of obstetric practice. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009;49(4):358-63.
6. Alfirevic Z, Neilson J. Biophysical profile for fetal assessment in high risk pregnancies (Cochrane Review). The Cochrane Library. 2004;3.
7. Mangesi L, Hofmeyr GJ, Smith V, Smyth RM. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database of Systematic Reviews. 2015(10).
8. Lowder milk D LSMWsHC, 9th Ed. China: Mosby Elsevier, P, 766-79.
9. Walsh LV. Midwifery: community-based care during the childbearing year: WB saunders Company; 2001.
10. Cronjé HS. Obstetrics in southern Africa: Van Schaik; 2003.
11. Sadovsky E, Yaffe H. Daily fetal movement recording and fetal prognosis. Obstetrics & Gynecology. 1973;41(6):845-50.
12. De Vries J, Fong B. Normal fetal motility: an overview. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2006;27(6):701-11.
13. Hijazi ZR ECFampofmOgs, 64(7), 489-97.
14. Tveit J, Saastad E, Bordahl P, Stray-Pedersen B, Frøen J, editors. The epidemiology of decreased fetal movements. Proceedings of the Norwegian Perinatal Society Conference; 2006.
15. Ricci S. Essentials of maternity, newborn, and women’s health: Lippincott Williams & Wilkins; 2020.
16. Sadovsky E, Polishuk WZ. Fetal movements in utero: nature, assessment, prognostic value, timing of delivery. Obstetrics and gynecology. 1977;50(1):49-55.
17. Swanson RW. Maternal Counting of Fetal Movements. Part II: Case Presentations. Canadian Family Physician. 1988;34:567.
18. Kumar SA. Vibroacoustic stimulation and modified fetal biophysical profile in high risk pregnancy. Journal Of Obstetrics And Gynecology Of India. 2007;57(1):37-41.
19. Rahimikian F, Modarres M, Niromanesh S, Mehran A, Rahiminia T. Effect of Halogen Light Stimulation on Nonreactive Pattern of Nonstress Test (NST). Hayat. 2011;17(2).
20. Bartnicki J, Dudenhausen J. Antepartum vibroacoustic stimulation in patients with low fetal heart rate variability. International Journal of Gynecology & Obstetrics. 1995;48(2):173-7.
21. Goonewardene M, Hanwellage K. Fetal acoustic stimulation test for early intrapartum fetal monitoring. Ceylon Medical Journal. 2011;56(1).
22. Rahimikian F, Rahiminia T, Modarres M, Mehran A. Comparison of halogen light and vibroacoustic stimulation on nonreactive fetal heart rate pattern. Iranian Journal of Nursing and Midwifery Research. 2013;18(2):112.
23. Manning F, Morrison I, Harman C, Lange I, Menticoglou S. Fetal assessment based on fetal biophysical profile scoring: In 19,221 referred high-risk pregnancies: II: An analysis of false-negative fetal deaths. American journal of obstetrics and gynecology. 1987;157(4):880-4.
24. AIUM Practice Parameter for the Performance of Limited Obstetric Ultrasound Examinations by Advanced Clinical Providers. (2018). J Ultrasound Med. 2018 , 1587-1596.
25. Wilailak S, Suthutvoravut S, Cherng‐sa‐ad P, Herabutya Y, Chaturachinda K. Assessment of fetal well‐being: Fetal movement count versus non stress test. International Journal of Gynecology & Obstetrics. 1992;39(1):23-7.
26. Niroomanesh Sh RMCotrontwrofmbtmatr, 7, 6-13.
27. Khooshideh M, Izadi S, Shahriari A, Mirteymouri M. The predictive value of ultrasound assessment of amniotic fluid index, biophysical profile score, nonstress test and foetal movement chart for meconium-stained amniotic fluid in prolonged pregnancies. Age (years). 2009;27:5.2.
28. Boog G. Maternal determination of fetal movements. A sure and simple method of monitoring the pregnancy. Revue Francaise de Gynecologie et D'obstetrique. 1988;83(11):693-5.
29. Singh G, Sidhu K. Daily fetal movement count chart: Reducing perinatal mortality in low risk pregnancy. Medical Journal Armed Forces India. 2008;64(3):212-3.
30. Tveit JVH, Saastad E, Stray-Pedersen B, Børdahl PE, Flenady V, Fretts R, et al. Reduction of late stillbirth with the introduction of fetal movement information and guidelines–a clinical quality improvement. BMC pregnancy and childbirth. 2009;9:1-10.
31. De Muylder X. The kick chart in high-risk pregnancies: a two-year experience in Zimbabwe. International Journal of Gynecology & Obstetrics. 1988;27(3):353-7.