MATERNAL PERCEPTION OF DECREASED FETAL MOVEMENTS IN TERM PREGNANCY AND ITS NEONATAL OUTCOME

Abstract

BACKGROUND: Movements of the fetus is a sign of fetal existence and welfare.1 Sensation of movements of the fetus by the mother are caused by the push against the abdominal wall due to gross fetal movement or limb movement. AIMS AND OBJECTIVES: 1. To identify antenatal risk factors related to decreased fetal movements like pre eclampsia, overt diabetes, oligohydramnios, abruptio placenta, placenta previa. 2. To evaluate perinatal outcome like low APGAR score, need for resuscitation, need for NICU admission, still birth, intrauterine death. MATERIALS & METHODS: Study site: The current study was conducted in the department of Obstetrics and Gynecology at RLJH hospital Kolar. Study subject : All pregnant women who complained of perception of reduced fetal movements at presentation and delivered at RLJH Hospital were considered as study population. Study design: The present study was a prospective observational study. Sample size: A total of 100 participants were considered in the study. RESULTS: A total of 100 women were investigated who belonged within the inclusion criteria. Antenatal history, CTG assessment, ultrasound for Biophysical profile, placental location were done and followed up till delivery. Neonatal outcome was noted using APGAR scores, NICU admission and Intrauterine death. Majority of the mothers who came with diminished fetal movements were between 21-25 years of age group (48%), Primigravida (48%), 49% presented at 37- 37+6 weeks of pregnancy. Multiple risk factors were identified, most common being Preeclampsia(20%). Popular (46%) pattern of reduced movements was both in frequency plus intensity. 56% women with less fetal movements had anteriorly placed placenta. Univariate regression analysis showed statistically significant association of decreased fetal movements with risk factors with many descriptive factors such as multigravida, gestational age 39- 40+6 weeks, intensity of fetal movement, perinatal outcome of IUFD, birth weight >= 2.5 kg. The strongest association was found with IUFD. (P value<0.023) CONCLUSION: Every pregnant woman who is anxious about decreased fetal movements should seek medical help. This study shows that there is a connection between risk factors and reduced fetal movements which is proved to be statistically significant. Adverse neonatal outcomes like intrauterine death and NICU admission were recorded. In most of the developing countries like India, pregnant women have to be educated regarding the importance of counting fetal movements and its poor neonatal outcome. They should be evaluated by detailed history taking, thorough investigation to identify factors causing threat, along with fetal well-being. Early presentation to the hospital, obstetric evaluation and prompt intervention can prevent adverse neonatal outcome.