Decreased fetal movements: Report from the International Stillbirth Alliance conference workshop.
fetal growth restriction
fetal movements
pregnancy
stillbirth
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
08 Dec 2023
08 Dec 2023
Historique:
revised:
15
10
2023
received:
28
05
2023
accepted:
24
10
2023
medline:
8
12
2023
pubmed:
8
12
2023
entrez:
8
12
2023
Statut:
aheadofprint
Résumé
Maternal reports of decreased fetal movement (DFM) are a common reason to present to maternity care and are associated with stillbirth and other adverse outcomes. Promoting awareness of fetal movements and prompt assessment of DFM has been recommended to reduce stillbirths. However, evidence to guide clinical management of such presentations is limited. Educational approaches to increasing awareness of fetal movements in pregnant women and maternity care providers with the aim of reducing stillbirths have recently been evaluated in a several large clinical trials internationally. The International Stillbirth Alliance Virtual Conference in Sydney 2021 provided an opportunity for international experts in fetal movements to share reports on the findings of fetal movement awareness trials, consider evidence for biological mechanisms linking DFM and fetal death, appraise approaches to clinical assessment of DFM, and highlight research priorities in this area. Following this workshop summaries of the sessions prepared by the authors provide an overview of understandings of fetal movements in maternity care at the current time and highlights future directions in fetal movement research.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Références
Frøen JF. A kick from within- fetal movement counting and the cancelled progress in antenatal care. J Perinat Med. 2004;32:13-24.
Levy M, Kovo M, Barda G, et al. Reduced fetal movements at term, low-risk pregnancies: is it associated with adverse pregnancy outcomes? Ten years of experience from a single tertiary center. Arch Gynecol Obstet. 2020;301(4):987-993.
Scala C, Bhide A, Familiari A, et al. Number of episodes of reduced fetal movement at term: association with adverse perinatal outcome. Am J Obstet Gynecol. 2015;213(5):678.e1-678.e6.
Bradford B, Cronin RS, McCowan LME, McKinlay CJD, Mitchell EA, Thompson JMD. Association between maternally perceived quality and pattern of fetal movements and late stillbirth. Sci Rep. 2019;9(1):9815.
Heazell AEP, Warland J, Stacey T, et al. Stillbirth is associated with perceived alterations in fetal activity - findings from an international case control study. BMC Pregnancy Childbirth. 2017;17(1):369.
Stacey T, Thompson JMD, Mitchell E, Ekeroma A, Zuccollo J, McCowan L. Maternal perception of fetal activity and late stillbirth risk; findings from the Auckland stillbirth study. Birth. 2011;38(4):1-6.
Winje BA, Roald B, Kristensen NP, Frøen JF. Placental pathology in pregnancies with maternally perceived becreased fetal movement - a population-based nested case-cohort study. PLoS One. 2012;7(6):e39259.
Warrander L, Batra G, Bernatavicius G, et al. Maternal perception of reduced fetal movements is associated with altered placental structure and function. PLoS One. 2012;7(4):e34851.
Pagani G, D'Antonio F, Khalil A, Papageorghiou A, Bhide A, Thilaganathan B. Association between reduced fetal movements at term and first trimester markers of impaired placental development. Placenta. 2014;35(8):606-610.
Heazell A, Frøen JF. Methods of fetal movement counting and the detection of fetal compromise. J Obstet Gynaecol. 2008;28(2):147-154.
Maulik D, Mundy D, Heitmann E, Maulik D. Umbilical artery Doppler in the assessment of fetal growth restriction. Clin Perinatol. 2011;38(1):65-82.
Dutton PJ, Warrander L, Roberts SA, et al. Predictors of poor perinatal outcome following maternal perception of reduced fetal movements - a prospective cohort study. PLoS One. 2012;7(7):e39784.
Higgins LE, Myers JE, Sibley CP, Johnstone ED, Heazell AEP. Antenatal placental assessment in the prediction of adverse pregnancy outcome after reduced fetal movement. PLoS One. 2018;13(11):e0206533.
Akselsson A, Lindgren H, Georgsson S, et al. Mindfetalness to increase women's awareness of fetal movements and pregnancy outcomes: a cluster-randomised controlled trial including 39 865 women. BJOG. 2020;127(7):829-837. doi:10.1111/1471-0528.16104
Grant A, Elbourne D, Valentin L, Alexander S. Routine formal fetal movement counting and risk of antepartum late death in normally formed singletons. Lancet. 1989;2:346-349.
Flenady V, Gardener G, Ellwood D, et al. My Baby's Movements: a stepped-wedge cluster-randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths. BJOG. 2022;129(1):29-41.
Norman JE, Heazell AEP, Rodriguez A, et al. Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial. Lancet. 2018;392(10158):1629-1638.
Hayes DJL, Dumville JC, Walsh T, et al. Effect of encouraging awareness of reduced fetal movement and subsequent clinical management on pregnancy outcome: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2023;5(3):100821.
Mangesi L, Hofmeyr GJ, Smith V, Smyth RM. Fetal movement counting for assessment of fetal wellbeing. In: The Cochrane Collaboration, ed. Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd; 2015. doi:10.1002/14651858.CD004909.pub3
Bellussi F, Po' G, Livi A, et al. Fetal movement counting and perinatal mortality: a systematic review and meta-analysis. Obstet Gynecol. 2020;135(2):453-462.
Thompson JMD, Wilson J, Bradford BF, et al. A better understanding of the association between maternal perception of foetal movements and late stillbirth-findings from an individual participant data meta-analysis. BMC Med. 2021;19(1):267.
Heazell A, Budd J, Li M, et al. Alterations in maternally perceived fetal movement and their association with late stillbirth: findings from the Midland and north of England stillbirth case-control study. BMJ Open. 2018;8(7):e020031.
Damhuis SE, Ganzevoort W, Duijnhoven RG, et al. The CErebro Placental RAtio as indicator for delivery following perception of reduced fetal movements, protocol for an international cluster randomised clinical trial; the CEPRA study. BMC Pregnancy Childbirth. 2021;21(1):285.
Tveit JVH, Saastad E, Stray-Pedersen B, et al. Reduction of late stillbirth with the introduction of fetal movement information and guidelines - a clinical quality improvement. BMC Pregnancy Childbirth. 2009;9(1):32.
Rådestad I, Doveson S, Lindgren H, Georgsson S, Akselsson A. Midwives' experiences of using the mindfetalness method when talking with pregnant women about fetal movements. Women Birth. 2021;34:e498-e504.
Williamson PR, Altman DG, Bagley H, et al. The COMET Handbook: version 1.0. Trials. 2017;18(S3):280.
Hayes DJL, Devane D, Dumville JC, Smith V, Walsh T, Heazell AEP. Development of a core outcome set (COS) for studies relating to awareness and clinical management of reduced fetal movement: study protocol. Trials. 2021;22(1):894.
ter Kuile M, Erwich JJHM, Heazell AEP. Stillbirths preceded by reduced fetal movements are more frequently associated with placental insufficiency: a retrospective cohort study. J Perinat Med. 2022;50(6):668-677.
Kalafat E, Khalil A. Clinical significance of cerebroplacental ratio. Curr Opin Obstet Gynecol. 2018;30(6):344-354.
Smies M, Damhuis SE, Duijnhoven RG, Leemhuis AG, Gordijn SJ, Ganzevoort W. Study protocol for a randomized trial on timely delivery versus expectant management in late preterm small for gestational age pregnancies with an abnormal umbilicocerebral ratio (UCR): the DRIGITAT study. Trials. 2022;23(1):619.
Mylrea-Foley B, Thornton JG, Mullins E, et al. Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol. BMJ Open. 2022;12(4):e055543.
Figueras F, Gratacos E, Rial M, et al. Revealed versus concealed criteria for placental insufficiency in an unselected obstetric population in late pregnancy (RATIO37): randomised controlled trial study protocol. BMJ Open. 2017;7(6):e014835.
Gardener G, Daly L, Bowring V, et al. Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements. Centre of Research Excellence in Stillbirth; 2017.
Christensen RD, Lambert DK, Baer VL, et al. Severe neonatal anemia from fetomaternal hemorrhage: report from a multihospital health-care system. J Perinatol. 2013;33(6):429-434.
O'Leary BD, Walsh CA, Fitzgerald JM, Downey P, McAuliffe FM. The contribution of massive fetomaternal hemorrhage to antepartum stillbirth: a 25-year cross-sectional study. Acta Obstet Gynecol Scand. 2015;94(12):1354-1358.
Cozzolino M, Magro Malosso ER, Perelli F, Franchi C, Coccia ME. Keep in mind foetomaternal haemorrage in case of reduced foetal movements: a successful obstetric management. J Obstet Gynaecol. 2017;37(1):100-102.
Wylie BJ, D'Alton ME. Fetomaternal hemorrhage. Obstet Gynecol. 2010;115(5):1039-1051.
Athiel Y, Maisonneuve E, Bléas C, et al. Reduced fetal movement during pregnancy: is the Kleihauer-Betke test really useful? J Gynecol Obstet Hum Reprod. 2020;49(10):101748.
Bataille P, Petit L, Winer N. Performance of the Kleihauer Betke test in the prediction of neonatal anemia. J Matern Fetal Neonatal Med. 2022;35(19):3670-3676.
Audette MC, Mclean K, Malkani N, Kingdom J, Sobel M. Diagnostic accuracy of Kleihauer-Betke (Kb) testing to predict fetal outcomes associated with fetomaternal hemorrhage: a retrospective cohort study. J Perinatol. 2022;42(1):91-96.
Beneventi F, Cavagnoli C, Locatelli E, et al. Mild-to-moderate foeto-maternal haemorrhage in the third trimester and at term of pregnancy: quantitative determination and clinical-diagnostic evaluation. Blood Transfus. 2018;16:302-306. doi:10.2450/2017.0316-16
McArdle A, Flenady V, Toohill J, Gamble J, Creedy D. How pregnant women learn about foetal movements: sources and preferences for information. Women Birth. 2015;28(1):54-59.
Bradford B, Maude R. Maternal perception of fetal movements in the third trimester: a qualitative description. Women Birth. 2018;31(5):e287-e293.
Bradford B, Cronin RS, McKinlay CJD, et al. A diurnal fetal movement pattern: findings from a cross-sectional study of maternally perceived fetal movements in the third trimester of pregnancy. PLoS One. 2019;14(6):e0217583.
Hayat TT, Nihat A, Martinez-Biarge M, et al. Optimization and initial experience of a multisection balanced steady-state free recession cine sequence for the assessment of fetal behavior in utero. Am J Neuroradiol. 2011;32(2):331-338.
Perinatal Society of Australia and New Zealand and Centre of Research Excellence Stillbirth. Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements with a Singleton Pregnancy from 28 weeks' Gestation. Centre of Research Excellence in Stillbirth; 2022. Accessed May 5, 2023. https://learn.stillbirthcre.org.au/wp-content/uploads/2023/05/DFM_Clinical-Practice-Guideline_V2.5_Mar2023.pdf