MATERNAL PERCEPTION OF DECREASED FETAL MOVEMENT AS AN INDICATION FOR ANTEPARTUM TESTING IN A LOW-RISK POPULATION

Maternal perception of decreased fetal movement has traditionally been used as an indication for fetal testing in high-risk patients. Two hundred ninety-two low-risk patients who presented with a complaint of decreased fetal movement were studied to determine the incidence of adverse outcome and need for further testing. Initial testing included a nonstress test and ultrasonographic examination. Five (1.7%) of the study group had fetal death on initial examination and 4.4% of patients required immediate delivery because of abnormal maternal or fetal evaluation. An additional 5.8% had abnormal fetal heart rate tracings that necessitated follow-up. Fifty-two percent of patients with normal initial evaluations underwent additional testing. There were no significant differences between patients undergoing additional testing, patients having no additional testing, and a low-risk nontested group with regard to adverse outcome. Fetal surveillance is indicated in low-risk patients with decreased fetal movement. Additional testing of patients with a normal initial evaluation and no further complaint of decreased fetal movement may not be necessary.