Decreased fetal activity in complications of pregnancy

Fetal activity expresses the fetal condition in utero. Absence of fetal movements may signify fetal distress. The reduction in fetal movements (FM) to 3 or less or their cessation for at least 12 h with audible heart beats was referred to by us as movement alarm signal (MAS). The rate of MAS in 662 complicated pregnancies was studied. There were 43 patients (6.5%) with MAS mainly in cases of fetal malformations and conditions associated with reduced uteroplacental blood flow. In 13 cases a nonintervention approach was undertaken and all the fetuses died in utero. The remaining 30 cases with MAS were delivered promptly, mainly by Cesarean section and live births resulted. Eight of these died neonatally. It is suggested that in cases of MAS the diagnosis of fetal distress should be verified by additional tests. Should fetal distress be confirmed, especially in cases of polyhydramnios, oligohydramnios and symmetrical growth retardation, every effort should be made to exclude fetal malformations before delivery is undertaken especially by Cesarean section.