Recommendation
1: Fetal Movement Counting
1. Daily monitoring of fetal movements starting at 26 to 32 weeks should be done in all pregnancies with risk factors for adverse perinatal outcome. (I-A)
2. Healthy pregnant women without risk factors for adverse perinatal outcomes should be made aware of the significance of fetal movements in the third trimester and asked to perform a fetal movement count if they perceive decreased movements. (I-B)
3. Women who do not perceive six movements in an interval of two hours require further antenatal testing and should contact their caregivers or hospital as soon as possible. (III-B)
4. Women who report decreased fetal movements (< 6 distinct movements within 2 hours) should have a complete evaluation of maternal and fetal status, including non-stress test and/or biophysical profile. Prior to considering an intervention for fetal well-being, an anatomical scan to rule out a fetal malformation should be done, if one has not already been done.
Management should be based upon the following:
- Non-stress test is normal and there are no risk factors: the woman should continue with daily fetal movement counting. (III-B)
- Non-stress test is normal and risk factors or clinical suspicion of intrauterine growth restriction intrauterine growth restriction/oligohydramnios is identified: an ultrasound for either full biophysical profile or amniotic fluid volume assessment within 24 hours. The woman should continue with daily fetal movement counting. (III-B)
- Non-stress test is atypical/abnormal: further testing (biophysical profile and/or contraction stress test and assessment of amniotic fluid volume) should be performed as soon as possible. (III-B)