Reduced fetal movement as a predictor of perinatal outcome


Background: Maternal perception of fetal movement is one of the first signs of fetal life and is regarded as a manifestation of fetal wellbeing. Aims: To evaluate reduced fetal movement as an effective predictor for the assessment of fetal condition and to improve fetal outcome by early detection of fetal hypoxia. Study Design and setting: A Co relational study carried out for a period of two years from Dec. 2010 - Dec. 2012 at Obstetrics and Gynecology Department of Al Yarmouk teaching hospital Baghdad Iraq. Patients and Methods: 200 patients with history of sluggish fetal movements from 32-41weeks gestation were admitted to the Obstetric ward during the study time for clinical evaluation and their biophysical profile score was recorded and were followed till delivery, the mode of delivery and neonatal outcome were recorded including APGAR score of newborn which was noted at one and five minutes and those having poor APGAR score were resuscitated and admitted to neonatal care unit. Results: During this study 200 patients were evaluated, 58 patients were primigravidas and 142 were multigravidas. Among 200 patients non reactive fetal heart was found in 64 cases. 120 patients had a biophysical profile score of 10/10, 44 patients had a score of 8/10 and 32 patients had a score of 6/10. In 4 patients with 4/10 score emergency caesarean section led to the delivery of neonates with low APGAR score. Majority of patients with normal biophysical profile score of 8-10/10 had good APGAR score. The rate of caesarean section was 34%. Concerning fetal outcome 70% of cases with good outcome, low APGAR score at five minutes (<610) in 14% of cases, meconium staining in 9% of cases, birth asphyxia in 6% and endotracheal intubation in 1% of cases. Conclusions: reduced fetal movement appears to be a serious complaint that should be further evaluated and is associated with a significant fetal compromise.