Fetal movements: A framework for antenatal conversationsShow others and affiliations
2023 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 36, no 3, p. 238-246, article id S1871-5192(22)00321-3Article in journal (Refereed) Published
Abstract [en]
BACKGROUND: Presentations for decreased fetal movements comprise a significant proportion of acute antenatal assessments. Decreased fetal movements are associated with increased likelihood of adverse pregnancy outcomes including stillbirth. Consensus-based guidelines recommend pregnant women routinely receive information about fetal movements, but practice is inconsistent, and the information shared is frequently not evidence-based. There are also knowledge gaps about the assessment and management of fetal movement concerns. Women have indicated that they would like more accurate information about what to expect regarding fetal movements.
DISCUSSION: Historically, fetal movement information has focussed on movement counts. This is problematic, as the number of fetal movements perceived varies widely between pregnant women, and no set number of movements has been established as a reliable indicator of fetal wellbeing. Of late, maternity care providers have also advised women to observe their baby's movement pattern, and promptly present if they notice a change. However, normal fetal movement patterns are rarely defined. Recently, a body of research has emerged relating to maternal perception of fetal movement features such as strength, presence of hiccups, and diurnal pattern as indicators of fetal wellbeing in addition to frequency.
CONCLUSION: Sharing comprehensive and gestation-appropriate information about fetal movements may be more satisfying for women, empowering women to identify for themselves when their baby is doing well, and importantly when additional assessment is needed. We propose a conversational approach to fetal movement information sharing, focusing on fetal movement strength, frequency, circadian pattern, and changes with normal fetal development, tailored to the individual.
Place, publisher, year, edition, pages
2023. Vol. 36, no 3, p. 238-246, article id S1871-5192(22)00321-3
Keywords [en]
Antenatal, Fetal movements, Foetal, Pregnancy, Pregnancy outcome, Prenatal
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:shh:diva-4613DOI: 10.1016/j.wombi.2022.09.003PubMedID: 36154793OAI: oai:DiVA.org:shh-4613DiVA, id: diva2:1702643
2022-10-112022-10-112023-05-25Bibliographically approved