Abstract
Objective
To examine the obstetric and perinatal outcomes of women presenting with reduced fetal
movement (RFM) during the third trimester, specifically in relation to the diagnostic
capacity of non-stress cardiotocography (CTG) used as the primary investigation in
this clinical scenario.
Study design
This was a retrospective population-based cohort study of pregnancy outcomes of all
women ≥28 weeks’ gestation with singleton pregnancies presenting during one calendar
year with maternal perception of RFM, all of whom underwent CTG at presentation. Main
outcome measures included: obstetric intervention (induction of labour, spontaneous
vaginal delivery, operative vaginal delivery, emergency caesarean section), and perinatal
outcome (subsequent perinatal death, low Apgar scores (<75), neonatal resuscitation and NICU admission).
Results
In all, 524 women presented with RFM and a live fetus, representing 7% of the antenatal
obstetric population; 284 women (54%) were nulliparous. The reassuring CTG group comprised
482 (92%) women in whom initial CTG was reassuring and 15 (3%) where a repeat tracing
within 1 h was reassuring. The non-reassuring/abnormal CTG group (n = 27, 5%) either underwent emergency delivery or comprehensive serial fetal assessment;
this group had significantly higher rates of emergency caesarean delivery, neonatal
resuscitation and NICU admission; the incidence of small-for-gestational-age infants
did not differ significantly. No perinatal death occurred in either group following
CTG.
Conclusion
Normal non-stress CTG is a reliable screening indicator of fetal wellbeing in women
presenting with perception of RFM in the third trimester; abnormal pregnancy outcomes
were more common when initial CTG was abnormal or persistently non-reassuring.
Keywords
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Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
May 19,
2011
Received:
May 4,
2010
Identification
Copyright
© 2011 Published by Elsevier Inc.
