Fetal kick charts ‘of no value’ in assessing reduced fetal movement
MedWire News: Fetal kick charts and movement counting should not form a part of fetal monitoring during pregnancy, recommend Irish clinicians who call for the development of good practice guidelines in assessing reduced fetal movements.
Julia Unterscheider and colleagues from Cork University Maternal Hospital conducted a review of the evidence on the assessment of reduced fetal activity in determining poor pregnancy outcomes.
They note that there is a lack of consensus on how many movements are regarded as normal or abnormal, with healthy fetuses moving between four and 100 times an hour and maternal perceptions of movements ranging from 4 to 94 percent of actual movements on ultrasound scanning.
Definitions of reduced fetal movement among midwives and obstetricians range from <10 movements in 2 hours to 12 in 24 hours.
The team says that, when assessing reduced fetal movements, the mother should undergo a basic assessment using symphyseal–fundal height measurement, cardiotocography, amniotic fluid index or deepest vertical pool assessment, or fetal biometry..
In contrast, umbilical artery Doppler velocimetry and fetal vibroacoustic stimulation testing are considered of limited value, while fetal movement counting and biophysical profiling are of no value.
In summary, the team writes: “We have described significant variation in clinical routines reported in the management of reduced fetal movements... This leads to clinical uncertainty for both pregnant women and healthcare professionals and may put patient safety at risk.”
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By Liam Davenport