What investigation is appropriate following maternal perception of reduced fetal movements?

It has been proposed that maternal perception of reduced fetal movements may be indicative of placental insufficiency, and that women who present with reduced fetal movements should be investigated for evidence of placental insufficiency. A retrospective case notes-based analysis of patients presenting with reduced fetal movements was undertaken. There were 92 live-born infants, the mean gestation at delivery was 39(+4) weeks. The median birth weight was 3,140 g. A total of 29.1% of infants had a birth weight of less than the 10th centile. A total of 35 women underwent ultrasound assessment of fetal growth and liquor volume. Measurement of symphyseal fundal height (SFH) had a greater specificity than a single ultrasound assessment in the prediction of IUGR at delivery. To reduce unnecessary intervention, SFH measurement may be used as a screening tool for those who merit ultrasound assessment of growth and umbilical artery Doppler.