Maternal perception of decreased fetal movement as an indication for antepartum testing in a low-risk population.
Maternal perception of decreased fetal movement has traditionally been used as an indication for fetal testing in high-risk patients. Two hundred ninety-two low-risk patients who presented with a complaint of decreased fetal movement were studied to determine the incidence of adverse outcome and need for further testing. Initial testing included a nonstress test and ultrasonographic examination. Five (1.7%) of the study group had fetal death on initial examination and 4.4% of patients required immediate delivery because of abnormal maternal or fetal evaluation. An additional 5.8% had abnormal fetal heart rate tracings that necessitated follow-up. Fifty-two percent of patients with normal initial evaluations underwent additional testing. There were no significant differences between patients undergoing additional testing, patients having no additional testing, and a low-risk nontested group with regard to adverse outcome. Fetal surveillance is indicated in low-risk patients with decreased fetal movement. Additional testing of patients with a normal initial evaluation and no further complaint of decreased fetal movement may not be necessary.
Whitty
J E
JE
Department of Obstetrics and Gynecology, Weiler Hospital, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461.
Garfinkel
D A
DA
Divon
M Y
MY
D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring; D005324:Fetal Movement; D005500:Follow-Up Studies; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D009035:Mothers; D010465:Perception; D011247:Pregnancy; D016216:Ultrasonography, Prenatal