Sundus Yousif Kellow *
* Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.
** Sulaimani Directorate of Health.
Maternal and Neonatal Outcome of Term Pregnancies Presented With Reduced Fetal Movemen
Maternal perception of fetal movements is the most common method to assess fetal wellbeing in most
communities nowadys. It is regarded as unstructured screening on which most pregnant women depend.
Significant reduction or sudden alteration in fetal movement is a potentially important sign of impending fetal
death. Studies of fetal physiology using ultrasound have demonstrated an association between reduced fetal
movement and poor perinatal outcome.
To observe the outcome of pregnancies presented with reduced fetal movement (RFM ) at term regarding
intra-partum complications, time and mode of delivery and neonatal outcome.
Setting and duration
A prospective case –control study. The data collected at Sulaimania Maternity Teaching Hospital throughout
the period from the 1st of September 2012 to the 1st of March 2013.
One-hundred low risk pregnant ladies at term were included in the study; fifty of them with reduced fetal
movements and the other fifty with good fetal movement. After taking full history and examination including
fetal heart rate and manual non stress test(MNST), they were sent to ultrasound (US) examination for amniotic
fluid index and Umbilical artery Doppler velocimetery. Then they were followed up until delivery when intrapartum
complications, mode of delivery and neonatal outcome were recorded and tabulated for comparison
between the two groups.
Regarding the mode of delivery, although the rate of C/S for fetal distress was more among the cases (45.8%)
than control (29.4%) it didn’t reach significant statistical difference. The number of stillbirth were just 2 babies
in the case group. There were significant neonatal complications as birth asphyxia 24% with meconium
aspiration syndrome 16%, seizures 10% and early neonatal death 6% in the studied (case) group.
Conclusion and recommendation
Reduced fetal movement is an important symptom that should be taken seriously and manage accordingly, to
reduce perinatal morbidity and mortality. Each maternity hospital should have a protocol to deal with every
pregnant presents with reduced fetal movement.
Keywords: RFM, kick count, Doppler, NST, hypoxia, meconium aspiration syndrome.