Reduced Fetal Movements

Question 1

What are key points with fetal movements?

Answer 1

No set pattern of movements

Do not delay if there is a reduction in movements

Question 2

What are physiological causes of RFM?

Answer 2

Fetal sleep
Anterior placenta <28/40
Mother busy 
Antenatal steroids
Smoking

Question 3

What are pathological causes of RFM?

Answer 3

Intrauterine death
Placental insufficiency
Polyhydramnios
Congenital defect

Question 4

Who should you refer to if <26 weeks?

Answer 4

Community midwife

Question 5

How is RFM investigatd?

Answer 5

Hx + RFs
Maternal obs + urinalysis
Auscultate fetal HR
CTG

Question 6

What are concerning risk factors with RFM?

Answer 6

BMI >30
Age <20 or >40
Diabetes
Smoker
Pre-eclampsia/HTN
>42 weeks
IUGR

Question 7

What do you do if it is 1st episode, normal CTG and no RFs?

Answer 7

Reassure + send home

Question 8

What do you do if it is 1st episode, normal CTG and RFs?

Answer 8

Growth scan if last one was >2 weeks ago

Question 9

What do you do if it is the 2nd or more episode with a normal CTG?

Answer 9

Growth scan if last one >2 weeks ago

Question 10

What do you do if CTG is abnormal or growth scan <2 weeks ago?

Answer 10

Senior obstetric review