Assessment of Fetal Health Should Be Based on Maternal Perception of Clusters Rather Than Episodes of Fetal Movements

Objective: To determine the level of correlation between mother and machine detected episodes and clusters of fetal movements and their association with fetal heart rate acceleration. Methodology: An observational study conducted on health pregnant women between 29-40 weeks gestation who were admitted in spurious labour to the Department of Obstetrics and Gynaecology, National University Hospital, Republic of Singapore. A continuous record of fetal heart rate and fetal movement was obtained using the fetal actocardiograph. Fetal movements felt by mother were also noted. If a continuous series of fetal movements were perceived over a period of 15 secs on more it was termed clusters of fetal movement. The presence or absence of acceleration in relation to these movements were noted. Results: There was a highly significant correlation between mother and machine in detection of clusters of fetal movements (r = 0.77, p < 0.001); for episodes of fetal movements, the correlation was weaker (r = 0.23, p < 0.05). All clusters of fetal movements perceived by the mother were recorded by the machine and were associated with fetal heart rate accelerations. Two or more accelerations within 3 minutes of the fetal movements were seen with 87.8% of clusters felt by mother compared with 66.7% detected by the machine (p = 0.01). In the 2,263 minutes of recording in 42 women, a cluster of fetal movements was felt at least every 25 minutes by the mother. Conclusion: Maternal perception of 1 or 2 clusters of fetal movements in 30 to 60 minutes may be as reliable as a non-stress test in reassuring good health. It would be less time consuming than the traditional count to 10 fetal movement chart and a more reliable indicator of fetal health than counting episodes of fetal movements.