Fetomaternal Outcome and its Associated Factors in Patients with Decreased Fetal Movements
DOI:
https://doi.org/10.51985/JBUMDC2025522Keywords:
Colour Doppler, Gestational age, Meconium Stained Liquor, Neontatal Intensive Care, Nonstress test, Perinatal MorbidityAbstract
Objective: To determine the fetomaternal outcome of antenatal patients with reduced fetal movements and its association with different maternal parameters.
Study Design And Setting: Prospective case control study Gynae Department of Khyber Teaching Hospital, Peshawar. Methodology: This study was conducted from 1st February 2022 to 31st July 2022.80 antenatal women at >34 weeks, reporting less fetal movements were included. Exclusion criteria was multiple pregnancies, refused consent, IUFD, congenital malformations, and <34 weeks gestation. Sampling technique was consecutive non probability sampling. After detailed history and examination, 20-minute non-stress test, Color Doppler and Ultrasonography (AFI)was assessed and recorded. NICU admission, perinatal morbidity, meconium stained liquor and APGAR score < 7 were recorded. Control group of
80 pregnant women, not reporting any reduction in fetal movements, at similar gestation, delivering within 48 hours of admission, was constituted. Descriptive statistics and Chi-square test were applied.
Results: 58 (73%) patients were 21-30 years old.63 (79%) were primiparous.57 (72%) were at term pregnancy. AFI was < 5 cm in 19(23.7%),15 had spontaneous labor, whereas 56 (67%) were induced. 54 (67%) had NVD, 9 (11.5%)instrumental delivery, and 17 (20%) Caesaraen section.16 (20%) with an AFI < 5 cm had NVD. Mean birth weight was 2.67+0.46 kg.68 had > 7 and 12 had < 7 APGAR, no perinatal mortality among the 14(20%) newborns admitted to NICU. Conclusion: Reduced fetal movenets are reliable method of assessing fetal well being. Primigravidae and term pregnancy are risk factors for RFM.
References
1. Kapaya H, Almeida J, Karouni F, Anumba D. Management
of reduced fetal movement: A comparative analysis of two
audits at a tertiary care clinical service. Eur J Obstet Gynecol
Reprod Biol. 2020;248:128-132. doi: 10.1016/j.ejogrb .2020.
03.040.
2. Das R, Jana N, Arora N, Sengupta S. Ultrasound assessment
of fetal hearing response to vibroacoustic stimulation. J
Matern Fetal Neonatal Med. 2020; 33(14):2326-2332. doi:
10.1080/14767058. 2018. 1548600.
3. Bellussi F, Po' G, Livi A, Saccone G, De Vivo V, Oliver EA,
Berghella V. Fetal Movement Counting and Perinatal
Mortality: A Systematic Review and Meta-analysis. Obstet
Gynecol. 2020;135(2):453-462. doi: 10.1097/AOG.
0000000000003645.
4. Sterpu I, Pilo C, Koistinen IS, Lindqvist PG, GemzellDanielsson K, Itzel EW. Risk factors for poor neonatal
outcome in pregnancies with decreased fetal movements.
Acta Obstet Gynecol Scand. 2020;99(8): 1014-1021. doi:
10.1111/aogs.
5. Bradford B, Cronin R, McKinlay C, Thompson J, McCowan
L. Maternally perceived fetal movement patterns: The
influence of body mass index. Early Hum Dev. 2020
;140:104922. doi: 10.1016/j.earlhumdev. 2019.104922.
6. Bekiou A, Gourounti K. Reduced Fetal Movements and
Perinatal Mortality. Mater Sociomed. 2020;32(3):227-234.
doi: 10.5455/msm.2020.32.227-234.
7. AlAmri N, Smith V. The effect of formal fetal movement
counting on maternal psychological outcomes: A systematic
review and meta-analysis. Eur J Midwifery. 2021 ;6:10. doi:
10.18332/ejm/145789.
8. Hantoushzadeh S, Gargari OK, Jamali M, Farrokh F, Eshraghi
N, Asadi F, Mirzamoradi M, Razavi SJ, Ghaemi M, Aski SK,
Panhi Z, Habibi GR. The association between increased fetal
movements in the third trimester and perinatal outcomes; a
systematic review and meta-analysis. BMC Pregnancy
Childbirth. 2024;24(1):365. doi: 10.1186/s12884-024-06547-
3.
9. Maeda T, Kobayashi O, Eto E, Inoue M, Sekiguchi K, Ihara
K. An Algorithm for the Detection of General Movements of
Preterm Infants Based on the Instantaneous Heart Rate.
Children (Basel). 2022;10(1) :69. doi: 10.3390/ children1
0010069.
10. Moniod L, Hovine A, Trombert B, Rancon F, Zufferey P,
Chauveau L, Chauleur C, Raia-Barjat T. Fetal Movement
Counting in Prolonged Pregnancies: The COMPTAMAF
Prospective Randomized Trial. Healthcare (Basel).
2022;10(12):2569. doi: 10.3390/ healthcare10122569.
11. Hui L, Marzan MB, Rolnik DL, Potenza S, Pritchard N, Said
JM, Palmer KR, Whitehead CL, Sheehan PM, Ford J, Mol
BW, Walker SP. Reductions in stillbirths and preterm birth in
COVID-19-vaccinated women: a multicenter cohort study of
vaccination uptake and perinatal outcomes. Am J Obstet
Gynecol. 2023 May;228(5):585.e1-585.e16. doi: 10.1016/j.ajog
.2022.10.040.
12. Damhuis SE, Ganzevoort W, Duijnhoven RG, Groen H, Kumar
S, Heazell AEP, Khalil A, Gordijn SJ. The CErebro Placental
RAtio as indicator for delivery following perception of reduced
fetal movements, protocol for an international cluster
randomised clinical trial; the CEPRA study. BMC Pregnancy
Childbirth. 2021;21(1):285. doi: 10.1186/s12884-021-03760-
2.
13. Housseine N, Browne J, Maaløe N, Dmello BS, Ali S, Abeid
M, Meguid T, Rijken MJ, Kidanto H. Fetal movement trials:
Where is the evidence in settings with a high burden of
stillbirths? BJOG. 2023;130(3):241-243. doi: 10.1111/1471-
0528.17249.
14. Radestad I, Pettersson K, Lindgren H, Skokic V, Akselsson
A. 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 clusterrandomised controlled trial. BMJ Open. 2021;11(6):e050621.
doi: 10.1136/bmjopen-2021-050621.
15. Akselsson A, Lindgren H, Georgsson S, Pettersson K, Steineck
G, Skokic V, Rådestad I. Mindfetalness to increase women's
awareness of fetal movements and pregnancy outcomes: a
cluster-randomised controlled trial including 39 865 women.
BJOG. 2020;127(7):829-837. doi: 10.1111/1471-0528.16104.
16. Nama, N. ., Ramzan, S. ., Umer Arain, S. ., Kasi, N. ., Bala,
M. ., & Mahar, T. . (2022). Maternal and Neonatal Outcome
of Women Having Decreased Fetal Movements in The Third
Trimester of Pregnancy: A Cross-Sectional Study: Maternal
and Neonatal Outcome of Women Having Decreased Fetal
Movements. Pakistan Journal of Health Sciences
2024;3(05):137–141. https://doi.org/10.54393/pjhs.v3i05.201
17. Monari F, Menichini D, Salerno C, Gei V, Facchinetti F, Neri
I. Women's perception of fetal movements and perinatal
outcomes: results of a prospective cohort study. J Matern
Fetal Neonatal Med. 2023;36(1):2193664. doi:
10.1080/14767058.2023.2193664.
18. Bradford BF, Cronin RS, Warland J, Akselsson A, Rådestad
I, Heazell AE, McKinlay CJD, Stacey T, Thompson JMD,
McCowan LME. Fetal movements: A framework for antenatal
conversations. Women Birth. 2023;36(3):238-246. doi:
10.1016/j.wombi.2022.09.003.
19. Thompson JMD, Heazell AEP, Cronin RS, Wilson J, Li M,
Gordon A, Askie LM, O'Brien LM, Raynes-Greenow C,
Stacey T, Mitchell EA, McCowan LME, Bradford BF. Does
fetal size affect maternal perception of fetal movements?
Evidence from an individual participant data meta-analysis.
Acta Obstet Gynecol Scand. 2023;102(11):1586-1592. doi:
10.1111/aogs. 14652.
20. Bashir S, Haq Aqsa IU, Niazi Q, Sadiq N, Khalil AK.Perinatal
Outcome in Women at Term with Reduced Fetal Movements.J
Soc Obstet Gynaecol Pak. 2022; 12(2):83-86
21. Habib F, Aslam M, Sadiq H, Sohail I, Asim M, Habib M.
Role of Abnormal Intrapartum CTG in Predicting Adverse
Fetal Outcome. J Soc Obstet Gynaecol Pak. 2023; 13(2):78-
81.
22. Turner JM, Flenady V, Ellwood D, Coory M, Kumar S.
Evaluation of pregnancy outcomes among women with
decreased fetal movements. JAMA. 2021;4(4):e215071. doi:
10.1001/jamanetworkopen. 2021. 5071.
23. Bekiou A, Gourounti K. Reduced Fetal Movements and
Perinatal Mortality. Mater Sociomed. 2020;32(3):227-234.
doi: 10.5455/msm.2020.32.227-234.
24. Camacho EM, Whyte S, Stock SJ, Weir CJ, Norman JE,
Heazell AEP. Awareness of fetal movements and care package
to reduce fetal mortality (AFFIRM): a trial-based and modelbased cost-effectiveness analysis from a stepped wedge,
cluster-randomized trial. BMC Pregnancy Childbirth.
2022;22(1):235. doi: 10.1186/s 12884-022-04563-9
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