Subjective recording of fetal movements. III. Screening of a pregnant population; the clinical significance of decreased fetal movement counts.

In order to determine the clinical significance of decreased fetal movement counts, pregnancy outcome was compared between women with decreased fetal movement counts on their Fetal Movement Charts (FMC) (n = 161) and women with normal fetal movement counts (n = 1,354). 1,515 women in the third trimester of pregnancy counted fetal movements for 15 min in the evening and noted the count on a FMC. An individual lowest normal limit for the number of fetal movements was calculated from the first five consecutive counts. A decrease in fetal movements was defined as two consecutive counts below the lowest limit (alarm signal). The alarm signal was associated with an increased risk of placental insufficiency (p less than 0.001) and imminent premature labor (p less than 0.001) and thereby indirectly with an increased risk of the birth of a baby with birth weight less than 2,500 g (p less than 0.05), preterm baby (p less than 0.05) or small-for-gestational age baby (p less than 0.05). The alarm signal was also associated with an increased risk of the birth of babies with congenital malformations (p less than 0.05), respiratory disturbances (p = 0.01) and hypoglycemia (p less than 0.05). The short-term method of fetal movement counting can be used to preselect a group of pregnant women whose unborn fetus is at particular risk.