Clinical Guidelines

Clinical practice guideline for the management of women who report decreased fetal movements

Clinical practice guideline for the management of women who report decreased fetal movements.
By Scott Preston, Kassam Mahomed, Yogesh Chadha, Vicki Flenady, Glenn Gardener, Julie MacPhail, Liz Conway, Laura Koopmans, Tomasina Stacey, Alex Heazell, Ruth Fretts and Frederik Frøen, for the Fetal Movement Study Group and the international FEMINA collaboration.

Low risk pregnancies in which women perceive a decrease in fetal movements have been found to be at increased risk for a number of adverse pregnancy outcomes including fetal growth restriction, preterm birth and antepartum fetal death. Maternal perception of DFM is not an uncommon event; it has been recorded that between 4-15% of pregnant women contact their health care provider because of concern about decreased fetal movements (DFM) in the third trimester of pregnancy. Yet, because of a lack of well-designed epidemiological studies on the patters of normal fetal activity and on maternal perception of fetal movements in normal pregnancies, the management of women reporting DFM during their pregnancy varies greatly and information provided to women is minimal. In recognition of the variation in clinical practice and the paucity of information provided to pregnant women regarding decreased fetal movements (DFM), the Fetal Movement Study Group at the Mater Mothers’ Research Centre has coordinated the development of this guideline for the Australian and New Zealand Stillbirth Alliance (ANZSA). Using an evidence based approach, this guideline aims to improve the management and outcome of care for women with DFM. The guideline covers 2 key areas, namely information provided to pregnant women regarding DFM, and management protocols for clinicians caring for women presenting with DFM. A number of clinical assessment methods are discussed, and recommendations for clinical practice are made based on the best available evidence. The guideline has been reviewed by the Fetal Movement Study Group in collaboration with ANZSA and will be updated in 2015.