Compliance with a Fetal Movement Chart by High-Risk Obstetric Patients in a Peruvian Hospital

ABSTRACT

We sought to determine the degree of compliance with a novel fetal movement chart (FMC) by high-risk patients versus the standard so-called count-to-10 method. This prospective trial included 1400 high-risk patients. Women with singleton gestations were randomly assigned to use either the count-to-10 chart or a FMC proposed by the Latin American Center for Perinatology (CLAP). Advantages and disadvantages were identified by patients. Compliance with regimens was measured and compared between the two groups. Demographic characteristics were similar. Compliance in the CLAP group (448 of 700) was lower than in the count-to-10 group (638 of 700; 64 versus 91%; p < 0.0001). The main advantage of the count-to-10 chart was lack of interference with daily activities. No intrauterine demises occurred in either group. High-risk patients were more compliant with the standard count-to-10 charting method than with the novel FMC. The count-to-10 method is an easy and inexpensive tool for fetal monitoring and should continue to be used in obstetric practice.

Fetal movement chart - compliance - count-to-10 chart - high-risk obstetric patients

REFERENCES

• 1 Rayburn W F. Antepartum fetal assessment: monitoring fetal body movements.  Clin Perinatol. 1982;  9 1-14
• 2 Froen J F. A kick from within-fetal movement counting and the cancelled progress in antenatal care.  J Perinat Med. 2004;  32 13-24
• 3 Fai F Y, Singh K, Malcus P, Biswas A, Arulkumaran S, Ratnam S S. Assessment of fetal health should be based on maternal perception of clusters rather than episodes of fetal movements.  J Obstet Gynaecol Res. 1996;  22 299-304
• 4 Gettinger A, Roberts A B, Campbell S. Comparison between subjective and ultrasound assessments of fetal movements.  BMJ. 1978;  2 88-91
• 5 Hertogs K, Roberts A B, Cooper D, Griffin D R, Campbell S. Maternal perception of fetal motor activity.  BMJ. 1979;  2 1183-1185
• 6 Rabinowitz R, Persitz E, Sadovsky E. The relation between fetal heart accelerations and fetal movements.  Obstet Gynecol. 1983;  61 16-18
• 7 Rayburn W F. Clinical applications of monitoring fetal activity.  Am J Obstet Gynecol. 1982;  144 967-980
• 8 De Muylder X. The kick chart in high-risk pregnancies: a two-year experience in Zimbabwe.  Int J Gynaecol Obstet. 1988;  27 353-357
• 9 Picquadio K, Moore T. A prospective evaluation of fetal movement screening to reduce the incidence of antepartum fetal death.  Am J Obstet Gynecol. 1989;  160 1075-1080
• 10 Harper R G, Greenberg M, Farahani G. Fetal movement, biochemical and biophysical parameters, and the outcome of pregnancy.  Am J Obstet Gynecol. 1981;  141 39-42
• 11 Leader I, Baillie P, Van Schalkwyk D J. Fetal movements and fetal outcome: a prospective study.  Obstet Gynecol. 1981;  57 431-436
• 12 Pearson J F, Weaver J B. Fetal activity and fetal well-being: an evaluation.  BMJ. 1976;  1 1305-1307
• 13 Mikhail M S, Freda M C, Merkatz R B, Polizzotto R, Mazloom E, Merkatz I R. The effect of fetal movement counting on maternal attachment to fetus.  Am J Obstet Gynecol. 1991;  165(4 pt 1) 988-991
• 14 Christensen F C, Olson K, Rayburn W F. Cross-over trial comparing maternal acceptance of two fetal movement charts.  J Matern Fetal Neonatal Med. 2003;  14 118-122
• 15 Smith C V, Davis S A, Rayburn W F. Patients' acceptance of monitoring fetal movement: a randomized comparison of charting techniques.  J Reprod Med. 1992;  37 144-146
• 16 Berbey R, Manduley A, Vigil-De Gracia P. Counting fetal movements as a universal tool for fetal wellbeing.  Int J Gynaecol Obstet. 2001;  74 293-295