Fetal movement monitoring: clinical application

Although many factors influence fetal movements, maternal perception of gross fetal movement appears to be an accurate reflection of fetal activity. Observation in humans and studies in animals indicate that the compromised fetus reduces its oxygen requirements by reducing activity. This fact has enabled perceived fetal movement to become a useful adjunctive test of fetal asphyxia in high-risk pregnancy. Its application to low-risk pregnancy has many attractions, particularly as approximately 50 per cent of stillbirths occur without obvious cause in normal pregnancies. Although studies suggest that such application would be beneficial, questions about acceptability, the burden of further testing precipitated by reports of diminished movement, and the perinatal implications of unwarranted early intervention need to be clarified before the universal application of fetal movement counting protocols can be recommended.