Decreased fetal movements: maternal and clinical responses

Decreased fetal movements: maternal and clinical responses

Weller, Megan (1), Gardener, Glenn (1), Ellwood, David (1), Warrilow, Kara (1), Sexton, Jessica (1), Wojcieszek, Aleena (1), Boyle, Francis M (1), East, Christine (1), Crowther, Caroline (2), Flenady Vicki (1)

1) Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia; 2) Robinson Research Institute, University of Adelaide, Adelaide, Australia

Background:
Stillbirth is a major global public health problem. Maternal perception of decreased fetal movements (DFM) is associated with stillbirth and other adverse outcomes. National best practice guidelines and information for women around DFM were first made available in Australia in 2016.

Methods:
Data were collected as part of the pre-intervention phase of the multi centre My Baby’s Movements (MBM) trial which is testing a mobile phone app for women and a clinician educational program to reduce stillbirth rates. Women with a singleton pregnancy at 28 weeks’ gestation or more presenting with DFM over a four week period across MBM participating sites in Australia and New Zealand were eligible for inclusion. Data collection spanned the period October 2016 to February 2018 and was undertaken by the attending clinician at the time of consultation or by research assistants.

Results:
844 women with DFM are included, representing 18.07% of all women birthing. At the time of consultation, 297 (35%) reported having concerns of DFM for 48 hours. Two women had fetal death upon presentation. Of the remaining women, 378 (42%) had a CTG as the only investigation for DFM. 165 women (19%) had an induction of labour/caesarean section after presenting with DFM. For the women who were not induced, 172 (25.3%) had additional follow up, 16 (2.4%) were admitted for further observation and 491 (72.3%) received standard or other antenatal care.

Conclusions:
Despite the availability of national best practice guidelines and information for women, areas for improvement in practices around DFM are evident. My Baby’s Movements aims to address this gap and improve pregnancy
outcomes.

Ethics statement:
Primary ethical approval was obtained from Mater Misericordiae Ltd Human Research Ethics Committee (EC00332) (MML HREC) in 2015. Further jurisdictional ethics approval was obtained from seven participating HRECs across Australia and New Zealand. Governance clearance was obtained for each of the 26 facilities involved in the trial.

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