Reduced Foetal Movements Flashcards
When are foetal movements usually first felt?
18-20 weeks
At what points of the day are foetal movements most active?
Afternoon/evening and following meals
How many foetal movements should be felt in 2 hours?
Approx 10 FM in 2 hours
What are the structural causes of RFM?
Uterus - fibroids, bicornate uterus
Placenta - anterior position
Cord - short, tangled
Fluid - polyhydramnios
What are the maternal causes of RFM? (“IM DAD PAPAS”)
Infection
Malnutrition
Dehydration
Alcohol
Drugs
Position
Adiposity
Perception
Activity
Smoking
What are the foetal causes of RFM? (3 P’s)
Physiological (baby sleeping)
Pathological (IUGR, congenital, chromosomal)
Position (towards mother’s back)
How is RFM investigated?
History and exam
Pinnard or Doppler sonicaid if <28 weeks
CTG
Ultrasound
What is the conservative management of RFM?
Hydration and regular meals
Lie on left side for two hours
Do not ignore RFM - present to hospital
How should RFM at <24 weeks be managed?
Check dates to see if foetus has started moving
Doppler sonicaid
Ultrasound
How should RFM at 24-28 weeks be managed?
Doppler sonicaid
Ultrasound
How is RFM at >28 weeks managed?
CTG
Ultrasound
Consider admission for repeat CTG
When can CTG first be performed?
28 weeks
