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

Abstract

To assess the reliability and application of maternal perception of sound provoked fetal movement for antepartum assessment of fetal well-being. 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. 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%). 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.