A review of the maternity care received by women presenting with decreased fetal movements

Dillon, P.L., Nagle, C., and Flenady, V. (2013) A review of the maternity care received by women presenting with decreased fetal movements. Journal of Paediatrics and Child Health, 49 (Supplement 1). P469. p. 128.

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Abstract

Background: Decreased fetal movements (DFM) are associated with adverse outcomes and the Australian and New Zealand Stillbirth Alliance (ANZSA) have developed clinical practice guidelines for the management of women who report DFM.

Method: A medical records review of women presenting to Barwon Health, Victoria, with DFM between 1 April 2010 and May 31 2012 was conducted to describe the characteristics of women presenting with DFM, the alignment of practice with ANZSA guidelines and birth outcomes.

Results: The records of 146 women presenting with DFM were reviewed. Thirty (20.5%) re-presented with DFM between 2–6 times (median 2). Women presented between 28–41 weeks (median 36 weeks). Complications were present in 88 (60.3%) women, including 11 (7.5%) with gestational diabetes, 42 (28.1%) with a BMI ≥ 30, 11 (7.5%) with hypertension disorder and 8 fetuses (5.5%) were growth restricted. Management was consistent with the guidelines for CTG which was performed for 141 (96.6%) and ultrasound biometry for 89 (61%) (recommended only if concerned after clinical assessment). The median time to review was 105 minutes however, 26 (17%) women were seen more than 2 hours after arrival (less than 120 minutes recommended) and fundal height was measured in only 81 (55.5%) women. Investigations were more likely to be conducted were the woman re-presented with DFM. There were four fetal deaths detected on initial presentation with DFM. Other outcomes included preterm births (n = 3), Agars <7 at 5 minutes (n = 11) and admissions to SCN (n = 13).

Conclusions: In this high risk population increased awareness of the ANZSA guidelines may increase alignment of practice with the guidelines and improve pregnancy outcomes.

Item ID: 51227
Item Type: Article (Abstract)
ISSN: 1440-1754
Additional Information:

Presented at the 17th Congress of the Perinatal Society of Australia and New Zealand, 14-17 April 2013, Adelaide, SA, Australia.

Date Deposited: 24 Oct 2017 02:53
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111006 Midwifery @ 100%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 100%
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