Maternal perception of fetal movement and perinatal outcome.

The maternal perception of fetal activity was studied in 306 clinic patients who counted for 2 predetermined hours each day. "Alarming" and "reassuring" fetal movement patterns were defined from statistical analysis. All reassuring fetal movement patterns were followed by reactive nonstress tests (NSTs), and the 2 nonreactive NSTs were preceded by alarming fetal activity. No relationship between urinary estriol determinations and prior fetal activity was present. Excluding congenital anomalies, perinatal distress was infrequent with prior reassuring fetal activity and arose primarily from intrapartum factors. An alarming fetal movement pattern was twice as frequent in high-risk pregnancies and was associated with a significantly greater risk of subsequent perinatal distress (P less than .0001). Clinical applications of the proposed technique are discussed.