Recommendations for foetal movement monitornig and assesment

Abstract

Reduced foetal movements or a change in the pattern of foetal movements may be associated with a poor perinatal outcome. In case of reduced foetal movements, inadequate response of physician-gynecologist and obstetrician is a factor that contributes to stillbirth. All pregnant women should be given information about the normal foetal movement. We recommend uniform instructions about fetal movement monitoring, a uniform method of foetal movement monitoring (modified “count to ten” method) and the useof a uniform table/chart for foetal movement recording. In case of maternal perception of less than ten movements within 2 hours, women should contact their maternity unit. Appointment is also necessary in case of changes in the pattern of foetal movements or a sudden significant prolongation of time to 10 moves count that persist over several days. The history and clinical examination help us detect high risk pregnancies. At every appointment we should monitor blood pressure and test urine for proteinuria. Clinical assessment of women with reduced foetal movements should include assessment of foetal size with the aim of detecting foetuses small for gestational age. CTG is needed to exclude foetal compromise if the pregnancy is over 28 weeks of gestation. Ultrasound scan assessment should be done if there are any additional risk factors for stillbirth, in case of pathological CTG and if the perception of reduced fetal movements persists despite a normal CTG.