Reduced fetal movements

Authors

  • Julia Unterscheider MRCPI,

    Specialist Registrar, Corresponding author
    1. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Wilton, Cork, Republic of Ireland Email: julia_unterscheider@hotmail.com
      Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Wilton, Cork, Republic of Ireland Email: julia_unterscheider@hotmail.com
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  • Richard Horgan MRCOG MRCPI,

    Clinical Research Fellow and Specialist Registrar
    1. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Cork, Republic of Ireland
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  • Keelin O'Donoghue PHD MRCOG,

    Consultant Senior Lecturer
    1. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Cork, Republic of Ireland
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  • Richard Greene MRCOG

    Professor of Clinical Obstetrics
    1. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Cork, Republic of Ireland
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Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Wilton, Cork, Republic of Ireland Email: julia_unterscheider@hotmail.com

Abstract

  • • Maternal perception of reduced fetal movements affects up to 15% of pregnancies.
  • • Reduced fetal movements cause concern and anxiety and can be associated with poor pregnancy outcome.
  • • Up to 29% of women complaining of diminished movements carry a small-for-gestational-age fetus.
  • • Multiple pathologies contibute to reduce fetal movements but in many pregnancies a cause is not found.

Learning objectives:

  • • To establish what is meant by ‘reduced fetal movements’.
  • • To understand the assessment tools for women presenting with reduced fetal movements.
  • • To identify the fetus at risk of stillbirth and poor perinatal outcome.
  • • To learn which investigations are useful and which are not, in order to apply appropriate assessment and management strategies.

Ethical issues:

  • • Lack of good data on the management of reduced fetal movements.
  • • Failure to recognise pregnancy pathologies in women presenting with reduced fetal movements.
  • • Variation in practice in addressing this condition, with the risk of adverse perinatal outcomes.
  • • Risk of producing iatrogenic problems through over-investigation and unwarranted intervention in a healthy fetus.

Please cite this article as: Unterscheider J, Horgan R, O'Donoghue K, Greene R. Reduced fetal movements. The Obstetrician & Gynaecologist 2009;11:245–251.

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