Reduced Fetal Movements

Question 1

What can RFM represent

Answer 1

Fetal compensation to reduce O2 consumption
Response to chronic hypoxia in utero
Reflects risk of stillbirth and fetal growth restriction

Question 2

Normal fetal movements timeline

Answer 2

Starts at 18-20wks, increase until 32wks and plateaus
Should not reduce

Mother will recognise pattern to movements

Question 3

Risk factors for reduced fetal movements

Answer 3

Maternal posture
Maternal distraction
Anterior placentas - decreased awareness of fetal movements
Medication (alcohol, opiates, BZ)
Anterior fetal postition
Body habitus - obese patients less likely to feel fetal movements
Amniotic fluid volume - oligo/polyhydramnios
SGA

Question 4

Investigations

Answer 4

Based off maternal perception

Handheld dopper/US
28wks+ - confirm FHR with doppler
-no FHR detected => immediate US
-FHR found => CTG to monitor for 20mins minimum

24-28wks or U24wks - confirm FHR with doppler

Not felt by 24wks => refer to maternal fetal medicine unit