The Value of Reporting Decreased or Absent Fetal Movements by Mothers in Predicting the Pregnancy Outcome

Dear Editor, Maternal complaint of decreased fetal movement is one of the alarms, which its delayed reporting could be associated with adverse pregnancy outcome. 1 Controlled trials have shown that fetal movement counting by the mother is the only promising antepartum test to reduce the mortality. 2 Reduction of fetal movement could be a marker of poor conditions like fetal hypoxia, stillbirth and fetal growth restriction. 3 The aim of this study was to examine whether decreased fetal movement after lateral lie down for an hour could be a valuable tool for revealing fetal health status. We conducted a cross sectional study recruiting 200 pregnant women, who were complaining of decreased fetal movement during three days prior to admission to Hazrate-e Zeinab Obstetrics Clinic, and Shahid Mostapha Khomeini and Imam Khomeini hospitals, Tehran, Iran from 2007 to 2009. Women with a term pregnancy (more than 37 weeks), single fetus, and decreased fetal movement to less than four per hour during the three days prior to the admission were included in the study. Those with concurrent obstetrics complications such as preeclampsia, severe placenta abroptia, placenta previa, and biophysical profile score equal to one were excluded from the study. Variables such as fetal movement count after mother lateral lying for one hour, birth weight, activity, pulse, grimace, appearance , and respiration (APGAR) score at the first minute, type of delivery, maternal age, gravidity, and biophysical profile were assessed by the same team via a checklist to predict the outcome of pregnancy. More advanced cares such as biophysical profile were provided, and follow-ups were considered until the time of delivery. Data were analyzed by Statistical Package for Social Sciences (SPSS version 16) using Chi square and unpaired t test, and a P value of <0.05 was considered statistically significant. The age of the participants was 27.73±3.85 years (range: 17-43 years). Fifty eight cases (29%) mentioned absent fetal movement, and 142 (71%) reported a decreased fetal movement. After the mothers lied laterally for one hour, 78 cases (39%) reported no move, 107 (53.5%) reported 1-4 moves, and 15 (7.5%) reported more than 4 moves. There was no significant difference in biophysical profile score or first minute APGAR score from mothers with normal and decreased fetal movement during one hour of lateral lying. Out of 142 cases with decreased fetal movement, 52 (28.18%) had abnormal biophysical profile score (<6) and abnormal first minute APGAR score …