Research

Below are details of research studies that have looked into fetal movement monitoring and stillbirth.

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Reduction of late stillbirth with the introduction of fetal movement information and guidelines

– a clinical quality improvement. BMC Pregnancy Childbirth 2009, 9(32).

Holm Tveit JV SE, Stray-Pedersen B, Bordahl PE, Flenady V, Fretts R, Froen JF:

Fourteen hospitals in Norway participated in this study which aimed to improve care by providing written information to pregnant women about Decreased Fetal Movement and to provide guidelines on Decreased Fetal Movement to health care providers. There was an overall decrease of stillbirths by 1/3, with no increase of preterm births, or need for neonatal care.

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Boston University Fetal Activity Study

The Boston University Fetal Activity Study is a long-term study of the development of fetal activity and how it relates to infant development after birth. Fetal movement is a valuable marker for current fetal functioning. It is easily noticed by the mother and can be helpful in detecting early signs of fetal distress. However, the long-term significance of the pattern of fetal movement is unknown, and determining postnatal correlates of how fetal movement develops is both scientifically and clinically useful.

The study is the dissertation project of Sonia Chawla and is being supervised by Professor Kimberly Saudino, Ph.D.The goal of the project is to study the pattern of fetal movement and how well it predicts development of activity level, temperament, and mental and motor abilities in early infancy.

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A kick from within

– fetal movement counting and the cancelled progress in antenatal care.

Department of Obstetrics and Gynecology, Rikshospitalet University Clinic, University of Oslo, Norway. j.f.froen@klinmed.uio.no

Interest for maternal fetal movement counting as a method of screening for fetal well-being boomed during the 1970’s and 1980’s. Several reports demonstrated that the introduction of counting charts significantly reduced stillbirth rates. However, in 1989, a large study appeared in The Lancet that annihilated research in this field by deeming charts ineffective. In retrospect, it seems evidence was lacking. This review revisits the subject of the significance of fetal movement counting in predicting outcome and reducing stillbirth rates. A structured search was performed to identify studies relating to pregnancy outcome and its association with maternal perception of fetal movements. Suspected preliminary or redundant material was excluded. Only publications from Western countries dating from after 1970 were included. Twenty-four studies were identified. Available data demonstrate that reduced fetal movements are associated with adverse pregnancy outcome, both in high and low risk pregnancies. Increased vigilance towards maternal perception of movements (e.g. by performing movement counting studies) reduces stillbirth rates, in particular stillbirths deemed avoidable. While screening for fetal well-being by maternal fetal movement counting can reduce fetal mortality rates, a resurrection in research activity is urgently needed to optimize its benefits.

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Reducing stillbirths: screening and monitoring during pregnancy and labour.

Haws RA, Yakoob MY, Soomro T, Menezes EV, Darmstadt GL, Bhutta ZA.

Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. rhaws@jhsph.edu

Screening and monitoring in pregnancy are strategies used by healthcare providers to identify high-risk pregnancies so that they can provide more targeted and appropriate treatment and follow-up care, and to monitor fetal well-being in both low- and high-risk pregnancies. The use of many of these techniques is controversial and their ability to detect fetal compromise often unknown. Theoretically, appropriate management of maternal and fetal risk factors and complications that are detected in pregnancy and labour could prevent a large proportion of the world’s 3.2 million estimated annual stillbirths, as well as minimise maternal and neonatal morbidity and mortality.

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Promoting Awareness Fetal Movements to Reduce Fetal Mortality Stillbirth,

a Stepped Wedge Cluster Randomised Trial. (AFFIRM)

This study is not yet open for participant recruitment.Verified January 2013 by University of EdinburghSponsor:University of Edinburgh

Rates of stillbirth in Scotland are among the highest in resource rich countries. The majority of stillbirths occur in normally formed infants, with (retrospective) evidence of placental insufficiency being the commonest clinical finding. Maternal perception of decreased fetal movements appears to be an early biomarker both of placental insufficiency and subsequent stillbirth.

A prospective evaluation of fetal movement screening to reduce the incidence of antepartum fetal death

Division of Obstetrics, Department of Obstetrics and Gynecology, U.S. Naval Hospital, San Diego, California

Fetal death is a tragedy for mother, family, and obstetrician. Recent reviews of fetal death indicate that nearly half occur in pregnancies that are not candidates for traditional antepartum testing. We conducted a prospective evaluation of the effectiveness of a fetal movement screening program in reducing the fetal mortality rate. During a 7-month control period, 2519 deliveries occurred, no formal fetal movement assessment was done, and the fetal mortality rate was 8.7 per 1000 births. During the study period, 1864 patients were delivered of infants and the fetal mortality rate was 2.1 per 1000 (X2 = 6.8, p < 0.01). During the study period the number of antepartum tests performed increased by 13%. Interventions for fetal compromise prompted by inadequte fetal activity tripled in the study period, resulting in a drop in fetal mortality among patients with decreased movement from 44 to 10 per 1000.

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