Antepartum fetal surveillance in the patient with decreased fetal movement

Myoung Ock Ahn, Jeffrey P. Phelan, Carl Vernon Smith, Nancy Jacobs, Susan E. Rutherford

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Whenever a patient has the subjective perception of decreased fetal movement, prompt evaluation in the form of antepartum fetal surveillance has been undertaken. The purpose of this report is to describe our experience with 489 pregnant women who came between Jan. 1 and Dec. 31, 1985 to our Antepartum Fetal Surveillance Clinic with this complaint alone or in association with another indication for fetal surveillance. Overall, 838 nonstress tests were performed, and the results were reactive, 93.2%; nonreactive, 6.8%; and fetal heart rate decelerations, 6.1 %. Comparison of the first nonstress test results between those with decreased fetal movement alone or in combination with another diagnosis demonstrated a similar incidence of nonreactivity and fetal heart rate decelerations. In those patients whose indication was decreased fetal movement alone, there was a 3.7 times greater likelihood of diminished amniotic fluid volume. When the last test within 7 days of delivery was analyzed, the decreased fetal movement alone group had a lower incidence of cesarean delivery, cesarean delivery for fetal distress, and Apgar scores <7 than patients with an additional indication for testing. In summary, decreased fetal movement continues to be an acceptable indication for fetal surveillance. Based on our retrospective experience, the most reasonable approach appears to be a combination of nonstress test and amniotic fluid volume assessment. Unless the patient has additional indications for fetal surveillance, the patient with decreased fetal movement with a reactive nonstress test and a normal amniotic fluid volume does not appear to warrant additional testing.

Original languageEnglish (US)
Pages (from-to)860-864
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume157
Issue number4
DOIs
StatePublished - Jan 1 1987

Fingerprint

Fetal Movement
Amniotic Fluid
Fetal Heart Rate
Deceleration
Fetal Distress
Apgar Score
Incidence
Pregnant Women

Keywords

  • Decreased fetal movement
  • amniotic fluid volume assessment
  • antepartum fetal heart rate testing
  • fetal acoustic stimulation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Antepartum fetal surveillance in the patient with decreased fetal movement. / Ahn, Myoung Ock; Phelan, Jeffrey P.; Smith, Carl Vernon; Jacobs, Nancy; Rutherford, Susan E.

In: American Journal of Obstetrics and Gynecology, Vol. 157, No. 4, 01.01.1987, p. 860-864.

Research output: Contribution to journalArticle

Ahn, Myoung Ock ; Phelan, Jeffrey P. ; Smith, Carl Vernon ; Jacobs, Nancy ; Rutherford, Susan E. / Antepartum fetal surveillance in the patient with decreased fetal movement. In: American Journal of Obstetrics and Gynecology. 1987 ; Vol. 157, No. 4. pp. 860-864.
@article{d7f1d73d8a6341b09775c2f70bab8a9f,
title = "Antepartum fetal surveillance in the patient with decreased fetal movement",
abstract = "Whenever a patient has the subjective perception of decreased fetal movement, prompt evaluation in the form of antepartum fetal surveillance has been undertaken. The purpose of this report is to describe our experience with 489 pregnant women who came between Jan. 1 and Dec. 31, 1985 to our Antepartum Fetal Surveillance Clinic with this complaint alone or in association with another indication for fetal surveillance. Overall, 838 nonstress tests were performed, and the results were reactive, 93.2{\%}; nonreactive, 6.8{\%}; and fetal heart rate decelerations, 6.1 {\%}. Comparison of the first nonstress test results between those with decreased fetal movement alone or in combination with another diagnosis demonstrated a similar incidence of nonreactivity and fetal heart rate decelerations. In those patients whose indication was decreased fetal movement alone, there was a 3.7 times greater likelihood of diminished amniotic fluid volume. When the last test within 7 days of delivery was analyzed, the decreased fetal movement alone group had a lower incidence of cesarean delivery, cesarean delivery for fetal distress, and Apgar scores <7 than patients with an additional indication for testing. In summary, decreased fetal movement continues to be an acceptable indication for fetal surveillance. Based on our retrospective experience, the most reasonable approach appears to be a combination of nonstress test and amniotic fluid volume assessment. Unless the patient has additional indications for fetal surveillance, the patient with decreased fetal movement with a reactive nonstress test and a normal amniotic fluid volume does not appear to warrant additional testing.",
keywords = "Decreased fetal movement, amniotic fluid volume assessment, antepartum fetal heart rate testing, fetal acoustic stimulation",
author = "Ahn, {Myoung Ock} and Phelan, {Jeffrey P.} and Smith, {Carl Vernon} and Nancy Jacobs and Rutherford, {Susan E.}",
year = "1987",
month = "1",
day = "1",
doi = "10.1016/S0002-9378(87)80073-X",
language = "English (US)",
volume = "157",
pages = "860--864",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Antepartum fetal surveillance in the patient with decreased fetal movement

AU - Ahn, Myoung Ock

AU - Phelan, Jeffrey P.

AU - Smith, Carl Vernon

AU - Jacobs, Nancy

AU - Rutherford, Susan E.

PY - 1987/1/1

Y1 - 1987/1/1

N2 - Whenever a patient has the subjective perception of decreased fetal movement, prompt evaluation in the form of antepartum fetal surveillance has been undertaken. The purpose of this report is to describe our experience with 489 pregnant women who came between Jan. 1 and Dec. 31, 1985 to our Antepartum Fetal Surveillance Clinic with this complaint alone or in association with another indication for fetal surveillance. Overall, 838 nonstress tests were performed, and the results were reactive, 93.2%; nonreactive, 6.8%; and fetal heart rate decelerations, 6.1 %. Comparison of the first nonstress test results between those with decreased fetal movement alone or in combination with another diagnosis demonstrated a similar incidence of nonreactivity and fetal heart rate decelerations. In those patients whose indication was decreased fetal movement alone, there was a 3.7 times greater likelihood of diminished amniotic fluid volume. When the last test within 7 days of delivery was analyzed, the decreased fetal movement alone group had a lower incidence of cesarean delivery, cesarean delivery for fetal distress, and Apgar scores <7 than patients with an additional indication for testing. In summary, decreased fetal movement continues to be an acceptable indication for fetal surveillance. Based on our retrospective experience, the most reasonable approach appears to be a combination of nonstress test and amniotic fluid volume assessment. Unless the patient has additional indications for fetal surveillance, the patient with decreased fetal movement with a reactive nonstress test and a normal amniotic fluid volume does not appear to warrant additional testing.

AB - Whenever a patient has the subjective perception of decreased fetal movement, prompt evaluation in the form of antepartum fetal surveillance has been undertaken. The purpose of this report is to describe our experience with 489 pregnant women who came between Jan. 1 and Dec. 31, 1985 to our Antepartum Fetal Surveillance Clinic with this complaint alone or in association with another indication for fetal surveillance. Overall, 838 nonstress tests were performed, and the results were reactive, 93.2%; nonreactive, 6.8%; and fetal heart rate decelerations, 6.1 %. Comparison of the first nonstress test results between those with decreased fetal movement alone or in combination with another diagnosis demonstrated a similar incidence of nonreactivity and fetal heart rate decelerations. In those patients whose indication was decreased fetal movement alone, there was a 3.7 times greater likelihood of diminished amniotic fluid volume. When the last test within 7 days of delivery was analyzed, the decreased fetal movement alone group had a lower incidence of cesarean delivery, cesarean delivery for fetal distress, and Apgar scores <7 than patients with an additional indication for testing. In summary, decreased fetal movement continues to be an acceptable indication for fetal surveillance. Based on our retrospective experience, the most reasonable approach appears to be a combination of nonstress test and amniotic fluid volume assessment. Unless the patient has additional indications for fetal surveillance, the patient with decreased fetal movement with a reactive nonstress test and a normal amniotic fluid volume does not appear to warrant additional testing.

KW - Decreased fetal movement

KW - amniotic fluid volume assessment

KW - antepartum fetal heart rate testing

KW - fetal acoustic stimulation

UR - http://www.scopus.com/inward/record.url?scp=0023616236&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023616236&partnerID=8YFLogxK

U2 - 10.1016/S0002-9378(87)80073-X

DO - 10.1016/S0002-9378(87)80073-X

M3 - Article

C2 - 3314515

AN - SCOPUS:0023616236

VL - 157

SP - 860

EP - 864

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 4

ER -