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Are increased fetal movements always reassuring?

Clare L Whitehead1,2, Nicole Cohen2, Gerard H A Visser3

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The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|February 13, 2019
PubMed
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Excessive fetal movements may signal fetal distress and stillbirth risk. Early assessment is crucial for identifying high-risk pregnancies and intervening to improve outcomes.

Keywords:
Asphyxiacord entanglementfetal seizureshypoxic-ischemic encephalopathyincreased fetal movementstillbirth

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Area of Science:

  • Maternal-Fetal Medicine
  • Perinatal Outcomes
  • Fetal Physiology

Background:

  • Reduced fetal movements are linked to stillbirth, but excessive movements are less understood.
  • Excessive fetal movements were historically associated with acute fetal distress and demise.
  • Recent data indicate excessive fetal movements precede stillbirth in 10-30% of cases.

Purpose of the Study:

  • To investigate the association between excessive fetal movements and adverse pregnancy outcomes.
  • To understand the potential causes of excessive fetal movements.
  • To highlight the clinical challenge in managing these pregnancies.

Main Methods:

  • Review of existing literature on fetal movements and stillbirth.
  • Analysis of emerging data on excessive fetal movements preceding fetal demise.
  • Clinical assessment strategies for pregnancies with excessive fetal movements.

Main Results:

  • Excessive fetal movements may indicate fetal distress, potentially due to seizure activity, asphyxia, or cord entanglement.
  • A significant percentage of stillbirths are preceded by episodes of excessive fetal movement.
  • Timely fetal assessment is critical for managing risk.

Conclusions:

  • Excessive fetal movements warrant careful evaluation due to their association with adverse outcomes.
  • Further research is needed to elucidate the mechanisms behind excessive fetal movements.
  • Improved clinical protocols for managing excessive fetal movements are necessary.