J A DiPietro1, K A Costigan, E K Pressman. 1. Department of Population and Family Health Sciences, Johns Hopkins University, Baltimore, Maryland 21205, USA. jdipietr@welchlink.welch.jhu.edu
Abstract
OBJECTIVE: This study evaluates the validity of Doppler-detected fetal movement by a commercially available monitor and investigates whether characteristics of maternal body habitus and the intrauterine environment affect its performance. METHODS: Fetal movement was evaluated in normal pregnancies using both ultrasound visualization and a fetal actocardiograph (Toitu MT320; Tofa Medical Inc., Malvern, PA). Data were collected for 32 min on 34 fetuses stratified by gestational age (20-25 weeks; 28-32 weeks; 35-39 weeks). Fetal and maternal characteristics were recorded. Comparisons between ultrasound-detected trunk and limb movements and actograph records were conducted based both on 10-s time intervals and on detection of individual movements. RESULTS: Time-based comparisons indicated agreement between ultrasound and actograph 94.7% of the time; this association rose to 98% when movements of less than 1 s duration were excluded. Individual movements observed on ultrasound were detected by the actograph 91% of the time, and 97% of the time when brief, isolated movements were excluded. The overall kappa value for agreement was 0.88. The actograph was reliable in detecting periods of quiescence as well as activity. These findings did not vary by gestational age. The number of movements detected by the actograph, but not the single-transducer ultrasound, significantly increased over gestation. Maternal age, parity, weight, height, or body mass index were not consistently associated with actograph validity. Characteristics of the uterine environment, including placenta location, fetal presentation, and amniotic fluid volume also did not affect results. CONCLUSIONS: The Toitu actograph accurately detects fetal movement and quiescence from as early as 20 weeks gestation and has utility in both clinical and research settings. Actographs are most useful for providing objective and quantifiable measures of fetal activity level, including number and duration of movements, while visualization through ultrasound is necessary for studies of movement quality, source, or mechanics.
OBJECTIVE: This study evaluates the validity of Doppler-detected fetal movement by a commercially available monitor and investigates whether characteristics of maternal body habitus and the intrauterine environment affect its performance. METHODS: Fetal movement was evaluated in normal pregnancies using both ultrasound visualization and a fetal actocardiograph (Toitu MT320; Tofa Medical Inc., Malvern, PA). Data were collected for 32 min on 34 fetuses stratified by gestational age (20-25 weeks; 28-32 weeks; 35-39 weeks). Fetal and maternal characteristics were recorded. Comparisons between ultrasound-detected trunk and limb movements and actograph records were conducted based both on 10-s time intervals and on detection of individual movements. RESULTS: Time-based comparisons indicated agreement between ultrasound and actograph 94.7% of the time; this association rose to 98% when movements of less than 1 s duration were excluded. Individual movements observed on ultrasound were detected by the actograph 91% of the time, and 97% of the time when brief, isolated movements were excluded. The overall kappa value for agreement was 0.88. The actograph was reliable in detecting periods of quiescence as well as activity. These findings did not vary by gestational age. The number of movements detected by the actograph, but not the single-transducer ultrasound, significantly increased over gestation. Maternal age, parity, weight, height, or body mass index were not consistently associated with actograph validity. Characteristics of the uterine environment, including placenta location, fetal presentation, and amniotic fluid volume also did not affect results. CONCLUSIONS: The Toitu actograph accurately detects fetal movement and quiescence from as early as 20 weeks gestation and has utility in both clinical and research settings. Actographs are most useful for providing objective and quantifiable measures of fetal activity level, including number and duration of movements, while visualization through ultrasound is necessary for studies of movement quality, source, or mechanics.
Authors: Janet A DiPietro; Katie T Kivlighan; Kathleen A Costigan; Suzanne E Rubin; Dorothy E Shiffler; Janice L Henderson; Joseph P Pillion Journal: Child Dev Date: 2010 Jan-Feb
Authors: Janet A DiPietro; Kathleen A Costigan; Priscilla Nelson; Edith D Gurewitsch; Mark L Laudenslager Journal: Biol Psychol Date: 2007-08-31 Impact factor: 3.251
Authors: Kate Walsh; Clare A McCormack; Rachel Webster; Anita Pinto; Seonjoo Lee; Tianshu Feng; H Sloan Krakovsky; Sinclaire M O'Grady; Benjamin Tycko; Frances A Champagne; Elizabeth A Werner; Grace Liu; Catherine Monk Journal: Proc Natl Acad Sci U S A Date: 2019-10-14 Impact factor: 11.205
Authors: Colleen Doyle; Elizabeth Werner; Tianshu Feng; Seonjoo Lee; Margaret Altemus; Joseph R Isler; Catherine Monk Journal: Dev Psychobiol Date: 2015-05-06 Impact factor: 3.038
Authors: Janet A DiPietro; Meghan F Davis; Kathleen A Costigan; Dana Boyd Barr Journal: J Expo Sci Environ Epidemiol Date: 2013-04-17 Impact factor: 5.563
Authors: Lauren M Jansson; Janet A Dipietro; Martha Velez; Andrea Elko; Heather Knauer; Katie T Kivlighan Journal: J Matern Fetal Neonatal Med Date: 2009-01