Reduced Foetal Movements Flashcards
What are normal foetal movements?
Foetal movements should be present by 20 weeks and increase until the 32nd week at which point they plateau – but there should be no reduction in the frequency. Babies do go through 30minutes sleep wake cycles and so movements vary from 4 in an hour to 100s in an hour.
How are foetal movements best felt?
Movements are best felt lying down on their left side and should be felt all the way up to labour.
When should mothers seek help regarding reduced or absent foetal movement ?
If foetal movements reduce at any points for an extended period of time, then mothers should contact their GP or maternity unit. Counting movements is not necessary it is merely what is normal for that baby.
How should a mother presenting with reduced foetal movements be explored?
Presentation with RFM should be investigated by exploring risk factors for Stillbirth and FGR. RFM is associated with FGR, SGA, placental insufficiency and congenital malformation.
What investigations should be undertaken in mothers with reduced foetal movements?
Auscultation of foetal heart
Foetal size and Fundal length
If foetal heart beat not confirmed then immediate USS – include abdominal circumference, estimated foetal weight and foetal morphology
If foetal heartbeat confirmed, then arrangements for a CTG should be made.
How should you manage a mother presenting with no previous foetal movements by 24 weeks?
If no foetal movements have never been felt by 24 weeks then referral to a specialist foetal medicine centre should be considered to look for evidence of neuromuscular conditions.
