Maternal perception of sound-provoked fetal movement as a test of antepartum fetal wellbeing.
Maternal perception of sound-provoked fetal movement test was studied on 506 occasions in 443 women with obstetric or medical antenatal risk factors after 26 weeks gestation. The response was compared with a nonstress test (NST) performed immediately after a three-second vibroacoustic stimulation with an electronic artificial larynx. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 497 occasions (97.3%) and was accompanied by a reactive NST on 484 occasions; giving a specificity of 99.6 per cent and a negative predictive value of 97.4 per cent. An inconclusive or negative response to sound (2.7%) had a sensitivity of 35.0 per cent and a positive predictive value for a nonreactive NST of 77.8 per cent. Results of sound-provoked fetal movement test and NST, performed within a week of delivery, in 434 women were compared with fetal outcome. The maternal perception of sound-provoked fetal movement test had better specificity (99.1% vs 96.9%), positive predictive value (55.6% vs 35.0%) for poor fetal outcome than the NST, although its sensitivity (50.0% vs 70.0%) and negative predictive value (98.8% vs 99.3%) were lower. Maternal perception of sound-provoked fetal movement test may suffice as an inexpensive and simple method of evaluating antepartum fetal well-being in risk situations. When the mother does not feel any sound provoked fetal movement, NST is then performed. This clinical application can be helpful in a primary health care setting where rapid assessment of fetal health at risk is required.
Chutiwongse
S
S
Department of Obstetrics & Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Tannirandorn
Y
Y
Sukcharoen
N
N
Witoonpanich
P
P
Snidvongs
W
W
Phaosavasdi
S
S
D000161:Acoustic Stimulation / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005324:Fetal Movement / Q000502:physiology*; D005328:Fetal Viability / Q000502:physiology*; D006801:Humans; D008425:Maternal Behavior; D010465:Perception / Q000502:physiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D013216:Reflex, Startle / Q000502:physiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013785:Thailand