The SOGC has produced a series of recommendations pertaining to the application and documentation of fetal surveillance in the antepartum and intrapartum period in order to decrease the incidence of birth asphyxia. These guidelines are intented for use by all health professionals who provide antepartum and intrapartum care in Canada.
The first recommendation of Guideline No. 197a – Fetal Health Surveillance: Antepartum Consensus Guideline (2018) – pertains to fetal movement counting:
- Daily monitoring of fetal movements starting at 26 to 32 weeks should be done in all pregnancies with risk factors for adverse perinatal outcome.
- 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.
- 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.
- 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 of women reporting decreased fetal movements is important. Many women who present with reduced fetal movements and a living fetus (30%) were falsely reassured only to have a subsequent stillbirth. Data also suggest that with decreased fetal movement counts, electronic fetal heart monitoring alone may not be sufficient to ensure fetal well-being.
For more information, please consult: