Publication:

Fetomaternal outcome in patients of decreased fetal movements after thirty-four weeks of gestation

Background Maternal perception of decreased fetal movements is a cause of concern and common reason for visits to the antenatal clinic or delivery room. Several studies have shown that a reduction or cessation of fetal movements may result in poor pregnancy outcome and magnified increased risks of serious perinatal morbidity and mortality. Aim and objectives were to determine the correlation between decreased daily fetal movement counts, NST, USG and Colour Doppler with maternal and fetal outcome.

Methods This study was a prospective observational study, conducted in department of obstetrics and gynecology at Surat municipal institute medical education and research medical college from January 2020 to June 2021.

Results The study group consisted of 83 patients between 34 to 40 weeks of gestation with Decreased fetal movements. 60.24% patients belonged to age group between 21-25 years. 60.22% patients were multigravida.87.95% patients were full term, 59.09% patients presented between 12-24 hours of duration with complain of decreased fetal movements. In view of NST results, 72.29% patients had reactive-NST. In ultrasonography, 27.10% had AFI 5 cm & all patients had normal color Doppler study.  60 patients had induced labor. 68.67% patients delivered vaginally. 42.10% of vaginal deliveries, 80% of Instrumental vaginal deliveries and 75% of LSCS had Meconium-stained liquor. 81.92% babies had APGAR score of >7 at birth. 84.33% had birth weight more than 2.5 kg 68.18% babies were admitted in NICU due to Meconium aspiration syndrome, followed by respiratory distress syndrome in 18.18% and birth asphyxia in 13.63% babies.

Conclusions Decreased fetal movement is a frequently occurring antenatal presentation, associated with poor perinatal outcomes. Daily fetal movement counts are very effective, cheap and reliable method to diagnose fetal compromise early. Methods like NST, USG and Colour Doppler study are helpful in the identification of causes and timely management of the patient with decreased fetal movements and helpful to diagnose the fetus at risk and their timely delivery.