Fetomaternal Outcomes of Low-Risk Females Presenting with Perceived Reduced Fetal Movements at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Objective: To determine the fetomaternal outcomes of low-risk females presenting with perceived reduced fetal movements at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Methods: This was a cross-sectional study among 133 females of gestation between 34–41 weeks presenting with a perception of reduced fetal movement, who were consecutively recruited. Pearson χ2 and Fischer’s exact tests of association were used to test the association between the non-stress test (NST) findings, biophysical profile (BPP) scores, and fetomaternal outcomes, where p≤0.05 was considered statistically significant. Results: A reactive NST finding was seen in 88 (66.2%) participants with 104 (78.2%) of all participants enrolled having a normal BPP score. Active management of the current pregnancy was offered to 89 (66.9%) of the participants, and 81 (60.9%) of the females had a vaginal delivery. Three quarters (76.7%) of the newborns had a 5-minute appearance, pulse, grimace, activity, and respiration (APGAR) score ≥7, 18 (13.5%) were resuscitated, 13 (9.8%) were admitted to the newborn unit, and four (3%) fresh stillbirths were noted. Both NST (p<0.001) and BPP (p<0.001) were good predictors of a 5-minute APGAR score ≥7, but poorly (p=0.086) predicted resuscitation. There was a statistically significant association between the NST findings and admission to newborn unit (p=0.034). Conclusion: A reactive NST is a good predictor of a 5-minute APGAR score greater than 7, and is associated with a reduced likelihood of both admission to the newborn unit and newborn resuscitation. Both reactive NST and normal BPP are good predictors of vaginal delivery as opposed to Caesarean delivery.