Daily Fetal Movement Counting Research Articles

Effect of antenatal corticosteroids on daily fetal movement count in pregnant women

Background: Fetal well-being is reflected in the fetal movements perceived by the mother. Corticosteroids are the most common therapy in clinical practice which can affect fetal activity. Aims and Objectives: The aim of this study was to evaluate the effect of dexamethasone administration on daily fetal movement count (DFMC) in pregnant women. Materials and Methods: A prospective and cohort study was performed in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital. A total of 100 pregnant women between gestational ages of 28 weeks and 38 weeks were enrolled in the study. They were asked to count DFMC on day 0, that is, before administration of injection dexamethasone, on day 2 (after 48 h of first dose), and during day 4 to 7. Women received injection dexamethasone 6 mg i.m. 4 doses at an interval of 12 h for various indications such as pre-term pre-labor rupture of membranes, placenta previa, pre-term labor, and previous cesarean. Outcome measures were changes in DFMC before and after dexamethasone administration. Results: DFMC was significantly reduced on day 2 of injection dexamethasone administration and returned to baseline values after 4th–7th days of receiving dexamethasone. Conclusion: Dexamethasone administration resulted in transient reduction in DFMC that mimics fetal compromise; hence, clinicians should be aware of this phenomenon to prevent iatrogenic pre-term birth of the fetus.

Effect of pre-pregnancy body mass index and gestational weight gain on fetal outcome

Fetaldevelopment and growth in uterus is most critical. Most commonly used indicator is birth weight for determining well-being of infant. Body mass index (BMI) of mother before pregnancy, pregnancy weight gain, and other factors related to behavior, socio-cultural as well as genetics influence the birth weight. To study effect of pre-pregnancy BMI and gestational weight gain on fetal outcomeHospital-based follow-up study was carried out among 189 antenatal women. Gestational age, weight, height, BMI and fetal growth were recorded. Regular sonography was carried out to rule out fetal congenital abnormalities and fetal well-being. Daily fetal movement count, fetal heart rate monitoring was carried out daily. Estimation of the “total pregnancy weight gain” was done by subtracting last measured weight before delivery from weight recorded at first visit in first trimester. Birth weight of the neonate was recorded within 24 hours of delivery. BMI before pregnanacy was normal in Majority (75.1%). Underweight women earlier to conception had either normal Gestational weight gain (GWG) or less than normal GWG. Their babies also had significantly low average birth weight compared to either normal weight females or overweight and obese before conception. Overweight and obese females before conception had higher incidence of gestational diabetes (GDM) and cesarean section. Normal weight females before conception had higher incidence of Pregnancy induced hypertension.Being underweight before conception is a risk factor for low birth weight babies whereas being overweight and obese before pregnancy is a risk factor for GDM.

Comparative Study between Effect of Dexamethasone and Betamethasone used for Fetal Lung Maturity on Daily Fetal Movement Count and Doppler Flow Velocity Waveforms

Comparative Study between Effect of Dexamethasone and Betamethasone used for Fetal Lung Maturity on Daily Fetal Movement Count and Doppler Flow Velocity Waveforms

Effect of Antenatal Betamethasone and Dexamethasone on Maternal Blood Glucose Levels, Fetal Movement, Nst Parameters, and Umbilical Artery Doppler

Background: The rationale of the study is to establish the time duration of recovery of disturbed sugar values and NST parameters following steroid administration and which drug has a lesser rate of hyperglycemia and lesser disturbance of DFMC and NST parameters, so as to advocate better drugs for fetal lung maturity. This study aims to compare the changes in maternal serum glucose levels, daily fetal movement count, NST parameters, and umbilical artery doppler following Betamethasone and Dexamethasone administration in antenatal women. Subjects and Method: The study design is a prospective observational cohort study. 100 pregnant patients, were recruited into 2 equal groups who received Betamethasone and Dexamethasone in Obstetrics & Gynaecology department, MLN Medical College, Prayagraj. The independent variables are Age, Gravidity, and BMI while the dependent variables are postprandial blood sugar values, Daily Fetal Movement Count, Fetal Heart Rate, Non-Stress Test Parameters, and Doppler Flow Veloci- metry of the Umbilical artery. Categorical variables were compared using the Chi-square test, while, for continuous variables T-test was used. Study instruments include Glucometer, Cardiotocography, and Ultrasound. Results: Significant changes in the glycemic profile and fetal movements were noted. The mean ± SD glucose rise after 24 hrs in Group A (Mean= 140.10; SD= 35.90) and group B (Mean= 113.26; SD= 27.90), with p<0.001. 54% and 24% women perceived reduced fetal movements (p = 0.002) while 14% and 12% women had reduced variability on NST (p = 0.766) in Group A and Group B respectively, with 66.6% and 85.71% showing reduced flow on Doppler. Conclusion: Antenatal Betamethasone as well as Dexamethasone administration causes significant changes in maternal hyperglycemia, FHR, and DFMC at 24hrs while changes were non-significant in NST parameters and Doppler. Maternal hyperglycemia resolved within 72hrs with a resolution of decreased fetal movement perception. Umbilical artery flow decreased 24 hrs following steroid administration with more profound changes with betamethasone.

True Umbilical Cord Knot Leading to Fetal Distress – an Obstetric Emergency

Background: Umbilical cord true knot is a rare condition which affects about 1% of all pregnancies. Though the incidence is lower, it often goes undetected in antenatal period despite the availability of prenatal sonography and may lead to a compromised fetal outcome as presented in this case. In this case the presence of true knot of umbilical cord was missed despite routine sonography done just 1 week prior to delivery, when patient presented to casualty with complains of decreased fetal movements since 24 hours. This modality is said to be associated with adverse fetal outcome such as birth asphyxia or in adverse cases intra uterine fetal demise. Risk factors include long cord, polyhydramnios, small sized fetus, etc.
 Case Summary: 27 years old gravida two, para two, with 1 live issue with k/c/o hypothyroidism with previous lesions came with complaints of decreased fetal movement since 24 hours at 36 weeks 3 days of gestational period. The patient recorded regular ANC checkups and routine investigations within normal limits. Her USG scan done at 34.2 wks showing single loop of cord around neck and normal doppler findings. On examination her vitals were normal .Her abdominal examination showed uterus of 34 wks size, longitudinal lie, cephalic presentation and irritable with mild contractions present with scar tenderness . Her FHS were present/irregular/112 bpm with less variability. On p/v examination os was admitting tip of finger, cervix soft, 25% effaced, station high up, presenting part vertex, membrane present. She was advised admission and a cardio-tocography (CTG) was done which showed recurrent deep atypical variable decelerations with decreased beat to beat variability. An emergent cesarean section was taken. Newborn was a female diagnosed with true umbilical cord knot, 2 cm away from fetal insertion with cord length of 84 cm. The baby was shifted to NICU in view of respiratory distress.
 Conclusion: Despite of modern day ultrasonography and Doppler studies, true umbilical cord knot still remains a lesser diagnosed entity and so every pregnant patients should be monitored carefully with a watch for daily fetal movement count (DFMC)and weekly non stress test (NST) for fetal well being.

Effect of Fetal Movement Count Training (FMCT) on Prenatal Bonding and Maternal Anxiety among Primigravida Women

Background: Fetal movements can have positive effects on maternal-fetalattachment beforebirth, because the fetusis more tangible with the mother after movement. Daily fetal movementcounting is a simple and non-invasive method that can be carried out by the mother in order to improve thematernal fetal attachment and toreduce the maternal anxiety for the better pregnancy outcome.Objectives: The main objective of the study was to assess the effect of fetal movement count training onprenatal bonding and maternal anxiety among primigravida.Methods: Quantitative approach with true experimental research design was adopted. Total 173 pregnantwomen were selected for the study using purposive sampling technique. Subjects were randomly assignedin to the experimental (n=87) and control group (n=86). Fetal movement count training was given toexperimental group. The training includes both instructions and demonstration on fetal movement count.Booklet contain the steps of fetal movement count and 28 days counting chart was provided to the pregnantwomen to make the them adhere to the count.The tools used to collect the data were as follows: (1)Demographic questionnaire, (2) Maternal Antenatal Attachment Scale and (3) Self structured Anxiety Scale.Baseline assessment was done on the 1stday and the training was implemented on the same day. Motherswere followed through phone calls. Post-assessment was done after 28days. The data wereanalysed usingdescriptive and inferential statistics.Result: The mean post-test prenatal bonding score in experimental group is 81.90±5.969 and in controlgroup is 77.57±7.459 which shows the significant difference in prenatal bonding score between both thegroups (t = 4.215 p = 0.00002). The mean post-test maternal anxiety score is prenatal bonding score inexperimental group is 34.69±6.719 and in control group is 35.17±6.809 which is not showing any significantdifference between both the groups (t = 0.471 p = 0.3191). There was a moderately negative correlationfound between pre-test prenatal bonding and maternal anxiety score as evidenced by r= -0.277 at p=0.0002which was statistically significant.Conclusion: Thus, the training regarding fetal movement count was effective in improving prenatal bondingand reducing maternal anxiety among primigravida.

Fetal movement counting is associated with the reduction of delayed maternal reaction after perceiving decreased fetal movements: a prospective study

Maternal perception of decreased fetal movement is associated with adverse perinatal outcomes. Although there have been several studies on interventions related to the fetal movements count, most focused on adverse perinatal outcomes, and little is known about the impact of the fetal movement count on maternal behavior after the perception of decreased fetal movement. We investigated the impact of the daily fetal movement count on maternal behavior after the perception of decreased fetal movement and on the stillbirth rate in this prospective population-based study. Pregnant women in Shiga prefecture of Japan were asked to count the time of 10 fetal movements from 34 weeks of gestation. We analyzed 101 stillbirths after the intervention compared to 121 stillbirths before the intervention. In multivariable analysis, maternal delayed visit to a health care provider after the perception of decreased fetal movement significantly reduced after the intervention (aOR 0.31, 95% CI 0.11–0.83). Our regional stillbirth rates in the pre-intervention and post-intervention periods were 3.06 and 2.70 per 1000 births, respectively. Informing pregnant women about the fetal movement count was associated with a reduction in delayed maternal reaction after the perception of decreased fetal movement, which might reduce stillbirths.

Fetal Movement Counting and Maternal Depression: A Randomized, Controlled Trial

Background: The women in pregnancy and postpartum are susceptible to psychological problems such as anxiety and depression. Many studies conducted on postpartum depression, but few studies have examined the depression in pregnancy and have focused on ways to treat it. Objectives: The purpose of present study was to detect the fetal movement counting on depression of mother in the third trimester of pregnancy. Methods: In a Randomized controlled trial, 66 women with a singleton pregnancy and mild and moderate depression based on Beck Inventory Scale, were randomly allocated either to perform daily fetal movement counting from 28 week to 37 (n = 32) or control group (n = 34). Analysis was performed with SPSS 16 and a P < 0.05 was considered significant. Results: In the intervention group, the mean of depression scores was 14.56 ± 4.66 at 28 weeks and 13.65 ± 4.00 at 37 weeks and the difference was significant. The mean difference was 0.90 (95% CI: 0.52 - 1.28, P < 0.001). Also a significant difference was found in the control group between the 28 and 37 weeks of gestation with a mean difference of 0.32 (95% CI: 0.01 - 0.62, P < 0.001). There was not a significant difference in the mean of depression scores between the intervention and control group at 28 weeks. Also the difference was not significant at 37 weeks of gestation. Conclusions: The level of depression was decreased at 37 weeks of gestation in the fetal movement counting and control group and the difference was not significant. The mother concern for reducing of fetal movements was similar in both groups.

Fetal Movement Counting—Maternal Concern and Experiences: A Multicenter, Randomized, Controlled Trial

Fetal movement counting may improve timely identification of decreased fetal activity and thereby contribute to prevent adverse pregnancy outcomes, but it may also contribute to maternal concern. This study aimed to test whether fetal movement counting increased maternal concern. In a multicenter, controlled trial 1,013 women with a singleton pregnancy were randomly assigned either to perform daily fetal movement counting from pregnancy week 28 or to follow standard Norwegian antenatal care where fetal movement counting is not encouraged. The primary outcome was maternal concern, measured by the Cambridge Worry Scale. Analysis was by intention-to-treat. The means and SDs on Cambridge Worry Scale scores were 0.77 (0.55) and 0.90 (0.62) for the intervention and the control groups, respectively, a mean difference between the groups of 0.14 (95% CI: 0.06-0.21, p<0.001). Decreased fetal activity was of concern to 433 women once or more during pregnancy, 45 and 42 percent in the intervention and control groups, respectively (relative risk=1.1, 95% CI: 0.9-1.2). Seventy-nine percent of the women responded favorably to the use of counting charts. Women who performed fetal movement counting in the third trimester reported less concern than those in the control group. The frequency of maternal report of concern about decreased fetal activity was similar between the groups. Most women considered the use of a counting chart to be positive.

Daily fetal movement count chart: Reducing perinatal mortality in low risk pregnancy

Background: A reduction or cessation of fetal movements (FMs) is frequently reported by pregnant women resulting in anxiety and concern. Formal counting of FMs by the pregnant woman could possibly identify the fetuses at risk. Methods: A prospective study was carried out over 500 booked cases after introducing daily fetal movement count (DFMC) Chart in the ninth month of pregnancy. Prior ultrasound (USG) was done in all cases. DFMC chart was used to record number of fetal movements perceived by patient for one hour after food (breakfast, lunch, dinner). Fetal movements were considered satisfactory if the count was three or more on each occasion. Result: During the study period, no fetus was lost after introduction of DFMC chart in the 250 cases that were given DFMC chart and delivered in our hospital (Nil perinatal mortality ). This was compared with 250 booked cases that were not given DFMC chart but had normal ultrasound done after completion of eight months of pregnancy and followed up. Five intrauterine deaths occurred in the ninth month in control group (2 % perinatal mortality). In the DFMC chart group, 15 patients were admitted with decreased fetal movements. Out of these, 12 were discharged after monitoring for three days and three cases were delivered. Conclusion: DFMC chart in ninth month of pregnancy helps in identifying at risk fetus in low risk pregnancies in absence of any other adverse factors necessitating early delivery.

Monitoring of normal pregnancies by daily fetal movement registration or hormone assessment. A random allocation study

SummaryA random allocation study was performed to compare the clinical value of daily fetal movement counting with that of hormone assessment (oestriol and hPL) in the monitoring of apparently normal pregnancies for fetal well-being. Patients with known risk factors and those in whom complications occurred during the study were excluded.In the group counting fetal movements, 577 women recorded 35 189 daily counts, for a mean of 70 days each. The group evaluated with hormone assessments had an average of five determinations of serum total oestriol and human placental lactogen. Patient compliances were 86·8 and 99·5 per cent, respectively.Women having hormone assessments were seen more often as outpatients but the frequencies of hospital admission were identical. Other aspects of management did not differ. Women making fetal movement counts more frequently designated their monitoring procedure as troublesome or expressed insecurity.The number of patients studied was inadequate to assess the methods for pred...

Daily fetal movement counting for periods of one hour

Daily fetal movement counting for periods of one hour

Screening Tool for Daily Fetal Movement

Knowledge of the expected pattern of fetal movements is important to both health care providers and childbearing women since altered patterns can signal fetal compromise. The daily fetal movement count (DFMC) chart, a tool that is inexpensive, uncomplicated and non-invasive, is a clinically effective means of screening for fetal well-being after 20 weeks' gestation. The DFMC requires pregnant women to begin a fetal movement count at a selected time each day, count 10 movements and record the elapsed time from the first to the tenth movement. Findings which would indicate possible danger to the fetus, and which should be reported immediately, include less than 10 movements in 12 hours; no perception of movement in an eight-hour period; a change in the usual pattern of fetal movement; or a sudden increase in violent fetal movements followed by complete cessation of movement. Development of fetal movement assessment, fetal movement recording methods, teaching patients the DFMC method and nursing implications are described in this article. Use of the DFMC by nurse practitioners can enhance the physical and emotional well-being of pregnant clients.

Daily fetal movement counting A valuable assessment tool

Fetal movements, since biblical times, have been viewed as a reassuring sign of a healthy pregnancy. If the fetus was active, both mother and the health care provider knew that the fetus was at least alive. It was not until the last 15 years that the obstetric community began to place greater emphasis on the importance of the fetal movements. At present, not only an absence of movement, but also a decrease or sudden change in the number or quality of movements should create alarm. This article reviews the growth in the usage of the fetal movement count through a review of the literature. Recommendations on choosing and/or modifying a counting method to fit your clientele also are presented.

Fetal activity in pregnancies complicated by systemic lupus erythematosus.

Fetal movements were assessed in 7 cases of systemic lupus erythematosus (SLE). The daily fetal movement count was lower than normal in 4 cases. Three patients with renal disease and raised blood pressure had decreased fetal movements until cessation and poor fetal outcome. Uncomplicated cases of SLE did not manifest cessation of fetal movement, and their fetal outcome was favorable. When a decrease in fetal movements becomes apparent and the condition is verified by other biophysical tests, the patient should be delivered provided the fetus is viable.

Fetal activity and fetal wellbeing: an evaluation.

The clinical value of the 12-hour daily fetal movement count (DFMC) as a test of antepartum fetal wellbeing was assessed. The lowest 2-5% of 1654 DFMCs recorded by 61 women who subsequently delivered healthy infants fell below 10 movements per 12 hours. This level was taken as the lower limit of normal for clinical purposes. A normal DFMC in a population at risk was associated with a satisfactory fetal outcome. A low DFMC was associated with a high incidence of fetal asphyxia, and when fetal death occurred fetal movements rapidly diminished and stopped 12 to 48 hours before death. The DFMC is a generally applicable method of monitoring fetal welfare during pregnancy which provides an inexpensive adjunct or even an alternative to the more expensive placental function tests in current use.