Reduced foetal movements

Question 1

when should foetal movements typically start ?

Answer 1

18-20 weeks
16-18 weeks in primigravida

usually plateau by 32 weeks

Question 2

at what gestation and foetal movements still haven’t been felt warrants investigation ?

Answer 2

24 weeks

arrange USS

Question 3

when should reduced foetal movements be investigated ?

Answer 3

< 10 movements within 2 hours

Question 4

what is the pathophysiology behind reduced foetal movements ?

Answer 4

foetus stops moving in an attempt to reduce oxygen consumption in a state of chronic hypoxia

Question 5

risk factors for reduced foetal movements ?

Answer 5

anterior foetal position 
anterior placenta 
central obesity 
polyhydramios and oligohydramnios 
small for gestation age 
distraction 
sitting or standing up 
benzodiazepines or opiates

Question 6

investigations for RFM?

Answer 6

if > 28 weeks

• 1st line handheld doppler
• if no heart beat then urgest USS
• if heart beat then CTG
• if still concern after heart beat on CTG then urgent scan

if < 28 weeks
- handheld doppler