General News and Gossip

Article in GP magazine highlights risks of reduced fetal movement

This is an extract from an article by Dr Ciaran Crowe, ST2 in obstetrics and gynaecology, Princess Royal Hospital, Haywards Heath, West Sussex as featured in GP magazine. It discusses the importance of fetal movements.

“Reduced fetal movements (RFM) are a common presentation in general practice and hospital obstetrics. RFM is perceived as a state of fetal compromise by the mother and often poses a dilemma of management for the clinician.

Although highly subjective, fetal movements have been defined as any kick, roll, slush or flutter reported by the mother.

One of the greatest challenges is the lack of consensus on what is a ‘normal’ number of fetal movements and over what specified time frame. Fetal movements vary from four to 100 every hour and so definitions of RFM based on counting less than 10 movements in two, 12 or 24 hours are unhelpful.

Research suggests a perception of RFM affects up to 15 per cent of pregnancies, with one study finding that in 55 per cent of cases where RFM had been reported a stillbirth occurred.

Following the Confidential Enquiry into Stillbirths and Deaths in Infancy, lack of prompt management has been recognised as a contributing factor for stillbirth.

Further concerns were raised over lack of education and therefore failure of mothers to report RFM, and a failure of the doctor to explain the importance of reporting changes in movements. Several studies suggest this may be related to the lack of consensus on definition between doctors and midwifes.

Nonetheless, 85 per cent of women will be concerned about fetal movements and therefore RFM must be managed robustly to avoid an adverse perinatal outcome.”

This is the reason mums are no longer advised to count a set number of kicks and instead should get to know their baby’s own pattern and report any change to that.


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