Fetomaternal outcome in patients of decreased fetal movements after thirty-four weeks of gestation

Authors

  • Anamika Majumdar Department of Obstetrics and Gynecology, SMIMER, Surat, Gujarat, India
  • Kallol Mallick Department of Community Medicine, SMIMER, Surat, Gujarat, India
  • Dhaval Patel Candor IVF center, Surat, Gujarat, India
  • Shikha Shah Department of Obstetrics and Gynecology, SMIMER, Surat, Gujarat, India
  • Tasmiya Padaya Department of Obstetrics and Gynecology, SMIMER, Surat, Gujarat, India
  • Ravina Vasava Department of Obstetrics and Gynecology, SMIMER, Surat, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232957

Keywords:

Fetomaternal outcomes, Fetal movements, Gestation

Abstract

Background: Maternal perception of decreased fetal movements is a cause of concern and common reason for visits to the antenatal clinic or delivery room. Several studies have shown that a reduction or cessation of fetal movements may result in poor pregnancy outcome and magnified increased risks of serious perinatal morbidity and mortality. Aim and objectives were to determine the correlation between decreased daily fetal movement counts, NST, USG and Colour Doppler with maternal and fetal outcome.

Methods: This study was a prospective observational study, conducted in department of obstetrics and gynecology at Surat municipal institute medical education and research medical college from January 2020 to June 2021.

Results: The study group consisted of 83 patients between 34 to 40 weeks of gestation with Decreased fetal movements. 60.24% patients belonged to age group between 21-25 years. 60.22% patients were multigravida.87.95% patients were full term, 59.09% patients presented between 12-24 hours of duration with complain of decreased fetal movements. In view of NST results, 72.29% patients had reactive-NST. In ultrasonography, 27.10% had AFI <5 cm and 72.90% had AFI >5 cm & all patients had normal color Doppler study.  60 patients had induced labor. 68.67% patients delivered vaginally. 42.10% of vaginal deliveries, 80% of Instrumental vaginal deliveries and 75% of LSCS had Meconium-stained liquor. 81.92% babies had APGAR score of >7 at birth. 84.33% had birth weight more than 2.5 kg 68.18% babies were admitted in NICU due to Meconium aspiration syndrome, followed by respiratory distress syndrome in 18.18% and birth asphyxia in 13.63% babies.

Conclusions: Decreased fetal movement is a frequently occurring antenatal presentation, associated with poor perinatal outcomes. Daily fetal movement counts are very effective, cheap and reliable method to diagnose fetal compromise early. Methods like NST, USG and Colour Doppler study are helpful in the identification of causes and timely management of the patient with decreased fetal movements and helpful to diagnose the fetus at risk and their timely delivery.

Metrics

Metrics Loading ...

References

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.

Arulkumaran S, Chua S. Obstetrics and gynecology for postgraduates. In: Ratnam SS, Bhasker RK, Arulkumaran S (eds). Hyderabad: Orient Longman; 1999:1;126-35.

Fernando A, Bhide D. Practical guide to high risk pregnancy and delivery. 4th ed. New Delhi: Elsevier; 2008: 17-22.

Eden RD, Seifert LS, Kodack LD, Trofatter KF, Killam AP, Gall SA. A modified biophysical profile for antenatal fetal surveillance. Obstet Gynecol. 1988; 71(3):365-9.

Ian D. Assessment of fetal wellbeing, In: Practical obstetric problems. 6th ed. New Delhi: BI Publications Pvt Ltd; 2007: 465-85.

Chamberlain PF. Ultrasound evaluation of amniotic fluid volume. Am J Obstet Gynaecol. 1984;150:245-9.

Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with the four quadrant technique at 36-42 week, gestation. J Reprod Med. 1987;32:540-2.

Nageotte MD, Michael P, Towers MD. Perinatal outcome with MBPP. Am J Obstet Gynaecol. 1994; 170:1672-6.

Clark SL, Nageotte MP, Garite TJ, Freeman RK, Miller DA, Simpson KR, et al. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol. 2013;209(2):89-97.

Barett JM, Sayter SL, Boehm JM. An evaluation of 1000 patients. Am J Obstet Gynaecol. 1981;141:153.

Miller DA, Rabello YA, Paul RH. The biophysical profile: antepartum testing in the 1990s. Am J Obstet Gynecol. 1996;174:812.

Sowmya KP, Padmasri R, Lalitha S. Modified biophysical profile in antepartum fetal surveillance of high-risk pregnancies. Int J Reprod Contracept Obstet Gynecol. 2017; 6:1854-8.

McCarthy CM, Meaney S, Donoghue KO. Perinatal outcomes of reduced fetal movements: a cohort study. BMC. 2016;16:169.

Saastad E, Winje BA, Pederson BS. Fetal movement counting improved identification of growth restriction and perinatal outcome-a multicenter, randomized controlled trial. Am J Obstet Gynecol. 2011;23:31-8.

Winje BA, Roislien J, Froen J. Management of category II fetal heart rate tracings: towards standardization of care. BMC. 2013;172:32-9.

Downloads

Published

2023-09-28

Issue

Section

Original Research Articles