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At least 55 records · Page 3Linked to original sources
PubMed1986

Subjective recording of fetal movements. III. Screening of a pregnant population; the clinical significance of decreased fetal movement counts.

In order to determine the clinical significance of decreased fetal movement counts, pregnancy outcome was compared between women with decreased fetal movement counts on their Fetal Movement Charts (FMC) (n = 161) and women with normal fetal movement counts (n = 1,354). 1,515 women in the third trimester of pregnancy counted fetal movements for 15 min in the evening and noted the count on a FMC. An individual lowest normal limit for the number of fetal movements was calculated from the first five consecutive counts. A decrease in fetal movements was defined as two consecutive counts below the lowest limit (alarm signal). The alarm signal was associated with an increased risk of placental insufficiency (p less than 0.001) and imminent premature labor (p less than 0.001) and thereby indirectly with an increased risk of the birth of a baby with birth weight less than 2,500 g (p less than 0.05), preterm baby (p less than 0.05) or small-for-gestational age baby (p less than 0.05). The alarm signal was also associated with an increased risk of the birth of babies with congenital malformations (p less than 0.05), respiratory disturbances (p = 0.01) and hypoglycemia (p less than 0.05). The short-term method of fetal movement counting can be used to preselect a group of pregnant women whose unborn fetus is at particular risk.

Adult↗
PubMed1990

[Ante partum monitoring of fetal status by maternal recording of fetal movement].

Perceived fetal activity is the oldest and least expensive technique for monitoring fetal well-being. The mother's awareness of a loss or a significant decrease in propulsive fetal activity has been traditionally regarded as a warning sign, especially when uteroplacental insufficiency is present. Many investigators have reported the value of daily fetal movement charting as a means for signalling fetal jeopardy and possible demise. Discerning between a physiological rest period and an abnormally low activity period is difficult but important. Several definitions of fetal inactivity according to maternal perception are described. The aim of our study was to detect abnormal fetal conditions by registering fetal body movements. For the evaluation we used the "Cardiff count to ten kick chart" developed by Pearson and Weaver. We evaluated 173 pregnant women after the 26th week of gestation in this way. Evidence for fetal inactivity are less than 10 movements/12 hours. 10% of the pregnancies showed fetal inactivity; half of them are expected to have an unfavourable outcome due to placental insufficiency and fetal distress during labour. Daily fetal movement charting is a simple and effective method for the detection of abnormal fetal conditions. It should be used in all high-risk pregnancies, especially in cases of incompatibility in the Rh-system, diabetes mellitus, and placental insufficiency. Our decision to intervene should not be based on fetal activity patterns alone, but the observation of fetal inactivity needs further investigation by ultrasonography (breathing activity, cardiac motion, lower limb and trunk motion, search for malformation, placental morphology and amniotic fluid volume) and cardiotocography.

Female↗
PubMed1985

[Evaluation of fetal movements with ultrasonic Doppler fetal actograph].

Fetal movements in each trimester were recorded objectively and continuously with an ultrasonic Doppler actograph that enables simultaneous tracing of fetal heart rate (FHR) and fetal movement (FM). The record with this method was compared with those of the ultrasonic B-mode and M-mode respectively. The onset of FM signal bursts and FHR acceleration was nearly synchronous and the transitory FHR increase associated with FM signal bursts showed a linear amplitude increment along with the progress of gestation. Fetal hiccup movements were recorded from 24 weeks of gestation and lasted between 4.3 minutes and 17 minutes with a rate of 25 to 28 per minute. No FHR acceleration was recognized in such movements. Maternal perception was 67.7% on average of FM signal bursts. Fetal movements in early pregnancy were detected in the 11th week of gestation (CRL 54 mm). Long-term recording of fetal movements was carried out between 9:30 and 17:00 and the alternation of active and resting phases was investigated. The resting phase lasted 20 minutes on average, (range, 10 to 36 minutes). The fetal activity was not influenced by the maternal food intake. It is clinically significant to evaluate the change in fetal movements objectively and continuously.

Circadian Rhythm↗
PubMed1993

Massive fetomaternal hemorrhage preceded by decreased fetal movement and a nonreactive fetal heart rate pattern.

BACKGROUND: Massive fetomaternal hemorrhage occurs in one in 1000 deliveries and has been associated with decreased fetal movements and a sinusoidal fetal heart rate (FHR) pattern. CASES: Three women presented with decreased fetal movements, nonreactive FHR patterns, and positive Kleihauer-Betke tests. All three were at a viable gestational age and were immediately delivered by cesarean. The three infants were severely anemic, with hemoglobin levels of 6.5, 5.3, and 5.1 g/dL, respectively. CONCLUSION: A patient who presents with decreased fetal movement associated with a nonreactive FHR pattern and a positive Kleihauer-Betke test of more than 140 mL should be considered for immediate delivery if the gestational age is consistent with neonatal viability.

Adult↗
PubMed1978

Fetal movements associated with fetal heart rate accelerations and decelerations.

In normal pregnant women, the relationship between the FHR and fetal movements (FM) was evaluated during 1,541 consecutive observed FM of at least 1 second's duration. Two observed FHR changes were: (1) accelerations and (2) accelerations followed by decelerations. An acceleration in FHR was observed in association with 91.2 per cent of all FM of 1 to 3 seconds' duration and with 99.8 per cent of FM of longer than 3 seconds' duration. FM were associated with an acceleration followed by a deceleration 66.7 per cent of the time. FM lasting longer than 1 second and associated with neither accelerations nor decelerations were seen 1.8 per cent of the time.

Female↗
PubMed1997

Maternal perception of sound provoked fetal movement for antepartum assessment of fetal well-being.

OBJECTIVE: To assess the reliability and application of maternal perception of sound provoked fetal movement for antepartum assessment of fetal well-being. METHODS: Six hundred singleton high risk pregnant women of at least 32 weeks gestation were studied on 684 occasions. The response was compared with a nonstress test (NST) performed before a 3 second vibroacoustic stimulation with an electronic artificial larynx. The result of maternal perception of sound provoked fetal movement was compared to the NST and the perinatal outcome using sensitivity, specificity, negative predictive value, positive predictive value, and accuracy. RESULTS: On 684 occasions, a positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 642 occasions (93.9%) and was accompanied by a reactive NST on 630 occasions; giving a specificity of 97.1% and a negative predictive value of 98.1%. Results of maternal perception of sound provoked fetal movement and NST, performed within a week of delivery, in 560 women were compared with perinatal outcome. The maternal perception of sound provoked fetal movement test had better sensitivity (64.7%) for poor perinatal outcome than the NST (58.8%). Both tests were not different in specificity (96.3% vs 96.5%), positive predictive value (35.5% vs 34.5%), negative predictive value (98.9% vs 98.7%), and accuracy (95.4% vs 95.4%). CONCLUSION: The findings suggested that maternal perception of sound provoked fetal movement may be an effective screening test to identify fetal compromise in antepartum period. This test is a simple and inexpensive test for evaluating fetal well-being in primary health care setting.

Acoustic Stimulation↗
PubMed1992

An evaluation of the importance of formal, maternal fetal movement counting as a measure of fetal well-being.

Maternal perception of fetal movements has, over the years, become recognised as a valuable tool for early detection of fetal compromise. Several studies published in the mid-1970s have demonstrated that a reduction or cessation in maternally perceived fetal movements may precede antepartum late fetal death by a day or longer. From these findings formal fetal movement counting emerged as a valuable, non-invasive method of assessing fetal well-being; the belief being that clinical actions taken on the basis of reduced fetal movement counting may prevent antepartum death or morbidity. Conversely, more recent studies have failed to demonstrate that there is a beneficial effect of a formal, fetal movement counting policy on antepartum death. It is not disputed that fetal movements are of clinical importance but it seems that routine daily counting of fetal movements by women followed by appropriate action when movements are reduced offers no advantages over formal inquiry about fetal movements during standard antenatal care. Thus, the application of formal, maternal fetal movement counting as a method of fetal surveillance to reduce late antepartum death must be questioned.

Female↗
PubMed1980

Fetal movements registered by the pregnant woman correlated to retrospective estimations of fetal movements from cardiotocographic tracings.

After reviewing 30 cardiotocographic tracings from 15 pregnant women who directly registered fetal movements (FM) on the cardiotocographic (CT) tracings, we have found no correlation between the actual number of FM and the FM found by retrospective estimation from CT tracings. Ours is the first study to show this lack of correlation. On the contrary, we have found that by using the "retrospective" or "indirect" methods, almost 90% of the FM are overlooked. This is a very important loss of information since registration of FM seems to be a good method for surveillance of the fetus at risk. We also discuss our own methods for overcoming these problems.

Female↗
PubMed2005

[Clinical practice variation in reduced fetal movements].

BACKGROUND: Reduced fetal movements imply a risk pregnancy. This condition is present in a significant proportion of pregnancies, but both the quality of information and that of clinical care is variable. MATERIAL AND METHODS: All delivery units in Eastern Norway and Bergen have registered all consultations for reduced fetal movements, as part of the international collaborative project "Fetal Movement Intervention Assessment" (Femina). Out of 23,933 deliveries, 1200 pregnancies were examined. In 1043 pregnancies the mother had spontaneously presented her concern over reduced fetal movements; these were included in analyses. Results are presented with a 95% confidence interval. RESULTS: Asphyxia, death, growth restriction or preterm birth occurred in 19.6% (16.6-22.6%) of cases, ranging between units from 9.1% to 26.5%. Standard procedures varied extensively; ultrasonography was used in 39.0% to 98.6% and Doppler in 4.5% to 74.6% of cases. There was an association between outcomes and the procedures used. Women who waited 24 hours with reduced or absent movements before contacting healthcare had increased risk. Among those with absent movements, 47% (42-52%) had such risk behaviour. INTERPRETATION: There is a need for quality improvements in the information to pregnant women as well as in the clinical management of affected pregnancies. This could have large health benefits. We propose new guidelines for information and management.

Cardiotocography↗
PubMed1989

Evaluation of maternal perception of sound-provoked fetal movement as a test of antenatal fetal health.

Maternal perception of sound-provoked fetal movement was correlated with the results of nonstress cardiotocography in 1097 women with obstetric or medical antenatal risk factors. Ninety-two percent of the mothers felt fetal movements with the stimulus; all but three had a reactive non-stress test (NST). These three women were taking multiple antihypertensive drugs and were less than 33 weeks' gestation. Of 88 patients with no maternal perception of sound-provoked fetal movement, ten had nonreactive NSTs. Ultrasound confirmed the absence of fetal movement to the stimulus. The outcome in nine of these ten cases suggested some evidence of fetal compromise. Maternal perception of sound-provoked fetal movement correlated well with the results of the NST; the sensitivity (76.9%), specificity (92.8%), and negative predictive value (99.7%) were all high, although the positive predictive value was only 11.4%. Maternal perception of sound-provoked fetal movement may suffice as an inexpensive and simple method of evaluating antenatal fetal well-being in risk situations. When the mother is doubtful or does not feel the sound-provoked fetal movement, NST is indicated to evaluate the fetal health.

Acoustic Stimulation↗
PubMed1991

[Studies on features of fetal movement and development of human fetus with use of fetal actogram].

In 167 normal fetuses at 26 to 41 weeks of gestation, features of fetal movement and fetal development were investigated with use of actocardiograph in connection with a microcomputer system. The signals of fetal movement obtained by actocardiograph were stored in a floppy disc every 250 ms for 5 minutes through an AD-converter, and were analyzed every 5 minutes with the computer to reveal 3-dimensional (3-D) histograms. The 3-D histogram of fetal movement was composed of number, amplitude and interval of the signals in 11 voltage steps between 0.05 and 0.55V. The histogram clearly indicated state of fetal behavior, being either resting or active state. Fetal movement such as rolling movement, breathing movement and hiccup could be also identified with the computer analysis. In 68 normal fetuses at 14 to 41 weeks of gestation, the cross-correlation between fetal movement and fetal heart rate (FHR) were examined with the computer analysis. Finally fetal responses to acoustic and light stimulation were evaluated with use of pure-tone generator and flashlight. Acoustic stimulation was carried out in 53 normal fetuses at 28 to 41 weeks and light stimulation was performed in 116 normal fetuses at 18 to 41 weeks of gestation. The fetal responses were evaluated with actocardiogram. As a result, 1) Frequency in active state decreased and resting state increased as gestational weeks advanced, and then the frequencies of both state remained constant after 37 weeks of gestation. Duration of resting state also increased from 26 weeks to 37 weeks. These observations may suggest that fetal behavior can be established by 37 weeks of gestation. 2) Frequency in rolling movement decreased until 37 weeks of gestation, and then the movement increased during 38-41 weeks. Frequency in breathing movement increased to 33 weeks of gestation, then it remained constant. Hiccup occurred most frequently at 30-33 weeks, and it decreased thereafter. The function in fetal respiratory movement may be accomplished by 33 weeks of gestation. 3) Positive cross-correlation between fetal movement and FHR was observed as gestational weeks advanced. The correlation coefficient increased from 14 weeks up to 41 weeks. Acceleration of FHR following fetal movement eventually occurred in fetuses at 16 weeks, but the onset of acceleration delayed than normally occurred in developed fetuses. The delay was shortened in fetuses at 24 weeks and this was comparable to the delay in developed fetuses. These results suggest that the linkage of the acceleration of FHR with fetal movement is established at 24 weeks of gestation.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗
PubMed1991

Maternal perception of sound-provoked fetal movement as a test of antepartum fetal wellbeing.

Maternal perception of sound-provoked fetal movement test was studied on 506 occasions in 443 women with obstetric or medical antenatal risk factors after 26 weeks gestation. The response was compared with a nonstress test (NST) performed immediately after a three-second vibroacoustic stimulation with an electronic artificial larynx. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 497 occasions (97.3%) and was accompanied by a reactive NST on 484 occasions; giving a specificity of 99.6 per cent and a negative predictive value of 97.4 per cent. An inconclusive or negative response to sound (2.7%) had a sensitivity of 35.0 per cent and a positive predictive value for a nonreactive NST of 77.8 per cent. Results of sound-provoked fetal movement test and NST, performed within a week of delivery, in 434 women were compared with fetal outcome. The maternal perception of sound-provoked fetal movement test had better specificity (99.1% vs 96.9%), positive predictive value (55.6% vs 35.0%) for poor fetal outcome than the NST, although its sensitivity (50.0% vs 70.0%) and negative predictive value (98.8% vs 99.3%) were lower. Maternal perception of sound-provoked fetal movement test may suffice as an inexpensive and simple method of evaluating antepartum fetal well-being in risk situations. When the mother does not feel any sound provoked fetal movement, NST is then performed. This clinical application can be helpful in a primary health care setting where rapid assessment of fetal health at risk is required.

Acoustic Stimulation↗
PubMed1988

[Evaluation of the fetal movements and accelerations of fetal heart rate in twin pregnancy].

In twin pregnancy, the fetal heart rates (FHR) of each fetus and uterine contraction were recorded simultaneously on a single recording chart by two cardiotocographs and a linear multichannel recorder. In addition, with a new technique, FHR and fetal movement (FM) signal bursts for each fetus were recorded similarly on a single recording chart by two ultrasonic Doppler actographs and an electronic polyrecorder. Simultaneous nonstress tests were done for 32 sets of twins at 28 to 41 weeks' gestation. The observed acceleration number in every gestational week increased till 38 weeks and this result was similar to that in singletons. Completely synchronous acceleration patterns in the 2 fetuses were observed in 654 recordings (31.4%) and asynchronous acceleration patterns in 1,108 recordings (53.1%). Simultaneous FHR and FM signal burst recordings were performed in 7 twin pregnancies. In about half of the 1,535 recordings, the FM signal bursts were synchronous between 2 fetuses, whereas they were asynchronous in the other half. Synchronous FM bursts in each gestational week decreased with time. Neurological independency between the twins was suggested by the results. The synchronous appearance of FM signal bursts with FHR accelerations of 2 fetuses was more pronounced in a uniovular twin than in a biovular twin.

Female↗
PubMed1981

Fetal movement, biochemical and biophysical parameters, and the outcome of pregnancy.

Fetal movements, fetal heart rate patterns, and serum estriol levels were prospectively monitored in 91 high-risk and normal pregnant women. In four women, there was cessation of fetal movements. In three of these cases, there were pathologic changes in fetal heart rate patterns, with one neonatal death. Of the 87 women who did not demonstrate cessation of fetal movements, one had changes in fetal heart rate patterns. The difference between the two groups was statistically significant (Z test: p less than 0.001). No correlation was found between fetal movements and serum estriol levels in this study. Daily recording of fetal movements can be used as an effective screening test, with high sensitivity and specificity for the fetus in utero. Cessation of fetal movement places the fetus in a high-risk category and should alert the physician to the need for non-stress tests.

Estriol↗
PubMed1999

Analysis of fetal movements by Doppler actocardiogram and fetal B-mode imaging.

We have presented that fetal surveillance may be enhanced by use of the fetal actocardiogram and by computerized processing of fetal motion as well as fetal B-mode ultrasound imaging. Ultrasonic Doppler fetal actogram is a sensitive and objective method for detecting and recording fetal movements. Computer processing of the actograph output signals enables powerful, detailed, and convenient analysis of fetal physiologic phenomena. The actocardiogram is a useful measurement tool not only in fetal behavioral studies but also in evaluation of fetal well-being. It reduces false-positive, nonreactive NST and false-positive sinusoidal FHR pattern. It is a valuable tool to predict fetal distress. The results of intrapartum fetal monitoring are further improved by the antepartum application of the actocardiogram. Quantified fetal motion analysis is a useful, objective evaluation of the embryo and fetus. This method allows monitoring of changes in fetal movement, as well as frequency, amplitude, and duration. Furthermore, quantification of fetal motion enables evaluation of fetal behavior states and how these states relate to other measurements, such as changes in FHR. Numeric analysis of both fetal actogram and fetal motion from B-mode images is a promising application in the correlation of fetal activity or behavior with other fetal physiologic measurements.

Echocardiography↗
PubMed1976

Ultrasound monitoring of fetal movements. A method for assessing fetal development?

Human fetal movements in utero have been analysed by conventional compound B-scan ultrasound techniques. With practice, movements of specific parts of the fetus can be readily recognised, and even as early as the 6th week after conception gross movements of the whole embryo are visible. Monitoring of fetal movements as an indication of normal or abnormal fetal development appears to have been neglected, and future studies in this important area of antenatal paediatrics are suggested.

Arm↗
PubMed1987

Maternal perception of sound-provoked fetal movements as a measure of fetal well-being.

Maternal perception of sound-provoked fetal movements was studied on 613 occasions in 259 risk pregnancies. The response was compared with a non-stress (N-S) test performed immediately after the sound stimulation. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 534 occasions (87%) and was always accompanied by a normal N-S test; sensitivity 100%. An inconclusive (3%) or negative response to sound (10%) had a specificity of 89% and a predictive value for a pathological N-S test of 19%. There was a positive correlation between inconclusive or negative test results and fetal growth retardation (P less than 0.01), fetal hypoxia (P less than 0.05) and neonatal mortality (P less than 0.05). This rapid test may have a place as a simple first-line screening test.

Acoustic Stimulation↗