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Reduced fetal movements

^1. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Wilton, Cork, Republic of Ireland Email: julia_unterscheider{at}hotmail.com (corresponding author)
^2. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Cork, Republic of Ireland
^3. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Cork, Republic of Ireland
^4. Anu Research Centre, University College Cork; and Cork University Maternity Hospital, Cork, Republic of Ireland

Key content:

• Maternal perception of reduced fetal movements affects up to 15% of pregnancies.
  
• Reduced fetal movements cause concern and anxiety and can be associated with poor pregnancy outcome.
  
• Up to 29% of women complaining of diminished movements carry a small-for-gestational-age fetus.
  
• Multiple pathologies contibute to reduce fetal movements but in many pregnancies a cause is not found.
  

Learning objectives:

• To establish what is meant by ‘reduced fetal movements’.
  
• To understand the assessment tools for women presenting with reduced fetal movements.
  
• To identify the fetus at risk of stillbirth and poor perinatal outcome.
  
• To learn which investigations are useful and which are not, in order to apply appropriate assessment and management strategies.
  

Ethical issues:

• Lack of good data on the management of reduced fetal movements.
  
• Failure to recognise pregnancy pathologies in women presenting with reduced fetal movements.
  
• Variation in practice in addressing this condition, with the risk of adverse perinatal outcomes.
  
• Risk of producing iatrogenic problems through over-investigation and unwarranted intervention in a healthy fetus.
  

Please cite this article as: Unterscheider J, Horgan R, O’Donoghue K, Greene R. Reduced fetal movements. The Obstetrician & Gynaecologist 2009;11:245–251.

Keywords amniotic fluid / cardiotocography / clinical assessment / fetal movements / maternal perception / ultrasound