FETAL MOVEMENTS IN UTERO - NATURE, ASSESSMENT, PROGNOSTIC VALUE, TIMING OF DELIVERY

  • 1 January 1977
    • journal article
    • research article
    • Vol. 50  (1) , 49-55
Abstract
Fetal movements in utero are an expression of fetal well-being. A sudden increase of fetal movements is a sign of acute fetal distress, such as in cases of cord complications or abruptio placentae. Decreased fetal movements are seen in cases of chronic fetal distress, e.g., preeclampsia and hypertension in pregnancy. In these cases a pronounced decrease up to cessation of fetal movements occurred before fetal death in utero while fetal heart beats were still audible for at least 12 h. This situation was called movements alarm signal (MAS). This sign points to a severely disturbed fetus and indicates impending intrauterine fetal death. Such a development is an indication for immediate delivery of the fetus, provided it is viable. High-risk pregnant women are instructed to assess and record fetal movements daily as a monitor of fetal condition. A special device which records fetal movements is used to confirm the woman''s assessment of fetal movement. Fetal movement monitoring was more reliable than the urinary estriol determination in predicting impending fetal death in utero. In cases of MAS, fetal heart rate (FHR) changes appear 1-4 days after the MAS has appeared. Meconium was found in only 50% of these cases. Increased fetal movements are manifested as a response to various stimuli such as sound, light, touch and ultrasound. Classification of high-risk pregnancies into 3 groups according to the hormone assays, enzyme assays, ultrasonic cephalometry, fetal movements and FHR is suggested.

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