MATERNAL AND NEONATAL OUTCOME OF TERM PREGNANCIES PRESENTED WITH REDUCED FETAL MOVEMENT

Abstract

Background 
 Maternal perception of fetal movements is the most common method to assess fetal wellbeing in most communities nowadays. It is regarded as unstructured screening on which most pregnant women depend.Significant reduction or sudden alteration in fetal movement is a potentially important sign of impending fetal death. Studies of fetal physiology using ultrasound have demonstrated an association between reduced fetal movement and poor perinatal outcome.
 Objectives
 To observe the outcome of pregnancies presented with reduced fetal movement (RFM ) at term regarding intra-partum complications, time and mode of delivery and neonatal outcome.
 Methods
 A prospective case –control study. The data collected at Sulaimania Maternity Teaching Hospital throughout the period from the 1st of September 2012 to the 1st of March 2013. One-hundred low risk pregnant ladies at term were included in the study; fifty of them with reduced fetal movements and the other fifty with good fetal movement. After taking full history and examination including fetal heart rate and manual non stress test(MNST), they were sent to ultrasound (US) examination for amniotic fluid index and Umbilical artery Doppler velocimetery. Then they were followed up until delivery when intrapartum complications, mode of delivery and neonatal outcome were recorded and tabulated for comparison between the two groups.
 Results
 Regarding the mode of delivery, although the rate of C/S for fetal distress was more among the cases (45.8%) than control (29.4%) it didn’t reach significant statistical difference. The number of stillbirth were just 2 babies in the case group. There were significant neonatal complications as birth asphyxia 24% with meconium
 aspiration syndrome 16%, seizures 10% and early neonatal death 6% in the studied (case) group.
 Conclusion
 Reduced fetal movement is an important symptom that should be taken seriously and manage accordingly, to reduce perinatal morbidity and mortality. Each maternity hospital should have a protocol to deal with every pregnant presents with reduced fetal movement.