Proposed management for reduced fetal movements: Five years' experience in one medical center

Objective. To assess the management of reduced fetal movements (RFM) based on repeated fetal movement counts, nonstress test (NST), and ultrasound examination. Methods. This is a retrospective cohort study carried out in a single tertiary maternity hospital. A total of 2393 women with singleton pregnancies at >28 weeks' were referred to obstetric triage with chief complaint of RFM. Persistent movement counts of <5/h and abnormal results of NST or ultrasound mandated an admission for further evaluation. Women with transient RFM and normal ultrasound and NST were discharged. We compared the outcome between these two groups. Maternal and perinatal parameters were compared between women who were admitted and those who were discharged home after evaluation. Results. A total of 2393 women were referred to obstetric triage with chief complaint of RFM, of whom 753 (31.5%) were admitted for further evaluation. Their demographic and obstetrical parameters were similar to those of the nonadmitted women, as were the fetal demise rates. NICU admission and cesarean section rates and low Apgar scores were significantly higher among admitted patients. Conclusion. RFM has a clinical significance as a predictor of adverse perinatal outcome. Our study suggests that repeated fetal movement counts, NST, and ultrasonography may identify women at risk for adverse perinatal outcome.