Objective Poor perinatal outcome after reduced fetal movements (RFM) is related to smaller fetal size on ultrasound scan, oligohydramnios and lower human placental lactogen (hPL) in maternal serum. We performed a feasibility study for an RCT of RFM management based on these parameters.
Methods Women with RFM ≥36 weeks gestation were invited to participate in a RCT comparing standard management (ultrasound scan if indicated, induction of labour (IOL) based on consultant decision) with intensive management (ultrasound scan, maternal serum hPL, IOL if either result was abnormal). Anxiety was assessed by state-trait anxiety index (STAI) before and after investigations for RFM. Rates of protocol compliance and IOL for RFM were calculated.
Results 137 women were approached, 120 (88%) participated. 2 women in the standard group did not complete the study. 20% of participants had a poor perinatal outcome. All women in the intensive group had ultrasound assessment of fetal size and liquor volume vs. 96.7% in the standard group. Although there was no difference in IOL rates overall, 50% of the intensive group had IOL for abnormal scan or low hPL after RFM vs. 25% of controls who had IOL for RFM (p < 0.01). STAI reduced for all women after investigations but this reduction was greater in the standard group (p = 0.02).
Conclusion Women are willing to participate in an RCT of management of RFM with a low rate of attrition. Investigations decrease maternal anxiety. Participants randomised to the intensive group were more likely to have IOL for RFM.
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