Maternal perception of fetal movements is the oldest and most commonly used method to evaluate fetal wellbeing. The investigation and management of reduced fetal movements (RFM) is complicated by a wide variation in the amount perceived by individual mothers and the paucity of good evidence to guide clinicians.
This survey was designed in line with the RCOG Green-top Guideline on Reduced Fetal Movements (February 2011) using www.surveymonkey.com and was distributed to all trainee and consultant obstetricians and all midwifery staff across Scotland.
200 responses were collected; 68% from midwives and 32% from obstetric trainees or consultants. 63% of responders were aware of the RCOG guideline on RFM; of these, 79% had read this guideline. Despite this, only 69% work in a unit which has a policy detailing investigations and management of women presenting with RFM. 80% of responders accepted “maternal perception of decreased fetal movements” as a definition of RFM and an indication to seek advice. Over 90% of responders routinely perform CTG (if greater than 28 weeks), blood pressure and urinalysis on women presenting with RFM. Less than 5% would routinely refer women with RFM for ultrasound examination without additional risk factors and only 67% of responders have access to this within 24 hrs or during the next working day. Surprisingly, 23% would never offer induction for RFM.
The results reveal the huge variation across Scotland when investigating and managing women presenting with RFM, highlighting the importance of further research into the issue and the development of nationally agreed policy.
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