Fetal movement monitoring

Monitoring fetal movement serves as an indirect measure of central nervous system integrity and function. The coordination of whole-body movement, which requires complex neurologic control, is similar to that of the preterm newborn infant. Short-term observations of the fetus are best performed using real-time ultrasound imaging or Doppler ultrasound. Daily fetal movement charting by the compliant patient is a worthwhile adjunct in determining the frequency of fetal surveillance tests in the office and in predicting abnormal FHR patterns and perhaps impending stillbirth. Monitoring has its greatest value when placental insufficiency is long-standing, and its routine role in low-risk pregnancies requires further clinical investigation. The presence of a vigorous fetus is reassuring. Perceived inactivity requires reassessment of any underlying antepartum complication and more precise evaluation by FHR testing or real-time ultrasonography before delivery is considered.