Decreased fetal movement: Is it an alarm to Obstetrician and Pregnant Lady?

Abstract

Introduction: Fetal activity serves as an indirect measure of the fetus central nervous system integrity and function. Regular fetal movement can be regarded as an expression of fetal wellbeing. Maternal perception of decreased fetal movement is associated with poor feto-maternal outcome. This study is to find out feto-maternal outcome in cases of decreased fetal movement, done by assessing fetal heart rate (FHR) correlating with cardiotocography (CTG) and USG (ultrasonography) findings, Apgar score and meconium in amniotic fluid.

Materials and method: This was a hospital based, prospective comparative study done in Patan Academy of Health Sciences, Lalitpur, Nepal. The sample size was 200; 100 cases of decreased fetal movement versus 100 cases of good fetal movement at same gestational age in weeks. Data processing was done in SPSS version 20.0 (SPSS, Chicago, IL, USA) and calculated by chisquare test. P value less than 0.05 was considered significant.

Results: Significant difference was found in fetal kick chart counting. In the decreased fetal movement group, 16% had oligohydraminos, 3% had polyhydraminos and 5% had non reassuring CTG and 4% had abnormal heart rate detected clinically. There was statistically significant difference observed between the two groups in labor induction, cesarean section, meconium stain liquor, cord around the neck and different neonatal morbidities.

Conclusion: Decreased fetal movement is associated with poor fetomaternal outcome. Improved vigilance, early identification, further evaluation with CTG, USG and proper management of these pregnancies have favourable pregnancy outcome.