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One-Year Review Of Reduced Fetal Movements In Izzat Ali Shah MCH Center: A Predictor Of Poor Perinatal Outcome

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Rani H, Salahuddin G, Naz A, Majeed N, Safdar F, Rafique S. One-Year Review Of Reduced Fetal Movements In Izzat Ali Shah MCH Center: A Predictor Of Poor Perinatal Outcome. JRMC [Internet]. 2023 Jun. 24 [cited 2024 Jul. 17];27(2). Available from:


Objectives: To find out common causes of reduced fetal movements. The purpose is to reduce perinatal morbidity and mortality.

Methodology: This Prospective, Observational study was conducted at Izzat Ali Shah Maternal and child health center, unit III Gynae, Wah medical college Wah Cantt, from January 2019 to December 2019. A total of participants 160, who presented in the antenatal outpatient or emergency department with reduced fetal movements, were included in the study. Patients in the active phase of labor were excluded from the study. Patients were followed up till delivery. All necessary information, investigations, and examination points were noted on the predesigned proforma. Data were analyzed by using SPSS version 22.

Results: Out of a total of 160 patients, 144 had alive and stable babies. Regarding the age group, out of 160, six patients were teenagers (3.75%), 98 (61.25%) were between 20-30 years, and 55(34.3%) were in the age group of 30-40 years. Regarding gestational age at presentation, 27 out of 160(16.8%) were between 30-35 weeks, 133(83.12%) was at 36-40 weeks. None of the patients presented below 30 weeks. Concerning the number of pregnancy, primigravida 82(51.25%), 60(37.5%) were multigravida, and 18 (11.25%) was grand multipara. Regarding medical history, anemia was seen in 31 patients (19.37%), pregnancy-induced hypertension in 20(12.5%), and 65 %( 104) has no significant medical history. Concerning past obstetrical history, 107(66.8%) fell under low-risk pregnancies, 18(11.25%) had previously normal deliveries but 08(05%) patients had H/O still births. Regarding placental position, 71(44.37%) had anterior, 71(44.37%) had posterior, and 18 (11.25) had fundal placenta. Regarding UAD, 136(85%) had normal umbilical artery Doppler, 13(8.12%) had altered, 06(3.75%) were Absent and 05 (3.12%) has reversed end diastolic flow. During study, 78(48.7%) had normal AFI, 69(43.12%) has Oligohydramnios, 10(6.25%) anhydramnios, while only 03(1.87%) had polyhydramnios.  Regarding birth weight, 122(76.25%) had average weight, 32(20%) were low birth weight and 05(3.12%) were very low birth weight. 61(38.12%) went into NICU, while 99(61.8%) no admission required.

Conclusion: Most common risk factor or cause of reduced fetal movements was reduced liquor, (79). Out of which 69 remained alive and stable after birth, while 15 had early neonatal deaths. The second cause found was abnormal umbilical artery Doppler,(24). Out of which, 14 had early neonatal deaths and intrauterine deaths. This study showed the increased obligation of care required by patients with decreased fetal movement. Although the number of live births is more as compared to demise, it results in increased neonatal unit admission rates, higher induction and cesarean section rates, higher surveillance demands, and an increased financial burden on parents. It signifies the need for more vigilance in this area of practice. But we can’t neglect the perception of a mother. Mother’s feelings are more important than any other test.


Delaram M, Jafarzadeh L. The effects of fetal movement counting on Pregnancy outcomes. J Clin Diagn Res. 2016; 10(2):22–4.

Yuri P, Izhar B S, Johnny Y, Moshe B A, Reut B. Pregnancy outcome of women presenting with decreased fetal movements. Obstet Gynecol Int J. 2018; 9:241‒5.

Olagbuji BN, Igbarumah S, Akintayo AA, Olofinbiyi BA, Aduloju PO, Alao OO. Maternal understanding of fetal movement in third trimester: A means for fetal monitoring and reducing stillbirth. Nigerian J of Clinical Practice. 2014; 4: 489-94.

Adam D Jakes, Rebecca W, Clare S, Lucy C Chappell. Reduced fetal movements. BMJ 2018; 360:1-4.

Practice Bulletin No. 145: Antepartum Fetal Surveillance. American College of Obstetrics and Gynecologists; 2014; 124:182–92.

Reduced fetal movements clinical guidelines. NHS intrapartum NICE guidelines. Registration no: 06034. Status: public. REVISED 2019.

Ahlam M, Ibrahim G, Nahed F, Hassan K. Effect of Left lateral position on Intrauterine Fetal Resuscitation among Pregnant women with Reduced Fetal Movements. Int. Journal of Nursing Didactics, 2018; 8: 247-56.

Anna A, Susanne G, Helena L, Karin P, Ingela R. Women’s attitudes, experiences and compliance concerning the use of Mindfetalness-- a method for systematic observation of fetal movements in late pregnancy. BMC Pregnancy and Childbirth. 2017:17:359-65.

Lohana RU, Khatri M, Hariharan C. Correlation of non-stress test with fetal outcome in term pregnancy (37-42 Weeks). Int J Reprod Contracept Obstet Gynecol. 2013; 2: 639-45.

Little SE, Caughey AB. Induction of Labor and Cesarean: What is the true Relationship? Clin Obstet Gynecol. 2015; 58:269–81.

Claire M, McCarthy S, Meaney, O’Donoghue. Perinatal outcomes of reduced fetal movements: a cohort study. BMC Pregnancy Childbirth. 2016; 16: 169. PMCID: PMC4950725

Mohr S A, Tsur A, Kalter A, Weismann B A, Gindes L, Weisz B. Reduced Fetal movement: factors affecting maternal perception. J Matern Fetal Neonatal Med 2016; 29:1318-21.

Emmanuel E, Emily B, Monisha S, Deepa R. Neonatal outcome of patients presenting with reduced foetal movements. 2016; 206:35-42. DOI:

Norman JE, Heazell A, Rodriguez A, Weir CJ, Stock SJE. Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomized trial. Lancet. 2018: 5; 112-5.

Froen JF. A kick from within—fetal movement counting and the cancelled progress in antenatal care. J Perinat Med 2004, 32: 13–24. PMID: 15008381.

Saastad E, Winje BA, Stray P B, Froen JF. Fetal movement counting improved identification of fetal growth restriction and perinatal outcomes—a multi-centre, randomized, controlled trial. 2011. 6; 389-93.

Anna A, Helena L, Susanne G, Karin P, Ingela R. Increased labor induction and women presenting with decreased or altered fetal movements - a population-based survey. PLOS ONE 2019;14:e0216216.

McCarthy CM, Meaney S, O’Donoghue K. Perinatal outcomes of reduced fetal movements: a cohort study. BMC Pregnancy Childbirth. 2016;16:1-6. PMID: 27430891.

Awad NA, Jordan T, Mundle R, Farine D. Management and Outcome of Reduced Fetal Movements- is Ultrasound Necessary? J Obstet Gynaecol. 2018 ;40:454-9.

Middleton P, Shepherd E, Crowther CA. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database (2018) Syst Rev 5: CD004945. PMID: 29741208.

Linde A, Radestad I, Pettersson K, Hagelberg L, Georgsson S. "Better safe than sorry"-Reasons for consulting care due to decreased fetal movements. Women Birth 2017; 30(5):376-81.

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