Decreased fetal movements in late pregnancy - importance today?
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AbstractConcerns for decreased fetal movements (DFM) is a frequent cause of unplanned health consultations throughout the third trimester ranging between 4 % - 16 % in various populations. In the present thesis, women in the third trimester who reported a concern for DFM were registered prospectively at fourteen delivery units from April 2004 to March 2007. The routine provision of information about FM, and guidelines for management of DFM, were implemented in November 2005. A perception of DFM was associated with adverse pregnancy outcomes. Women were often poorly informed about the significance of FM and no evidence based guidelines for management existed. Maternal characteristics and the duration of the perceived decrease of FM were characteristics that helped in identifying pregnancies that could be targeted for intensified management. Improved management of DFM and provision of uniform information to women was associated with improved perinatal outcome. The findings suggest that women experiencing DFM in late pregnancy are at risk for adverse pregnancy outcome. Information may increase maternal awareness toward fetal activity and help the expectant mother to identify significant changes. Time matters and knowledge-based information to women are needed. Improved definitions of DFM and randomized controlled trials are needed to identify the optimal management of pregnancies with DFM.
List of papers
|Paper I: Tveit JVH, Saastad E, Stray-Pedersen B, Børdahl PE, Frøen JF. Maternal characteristics and pregnancy outcomes in women presenting with decreased fetal movements in late pregnancy. Acta Obstetricia et Gynecologia. 2009; 88: 1345-1351. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.3109/00016340903348375|
|Paper II: Tveit JVH, Saastad E, Stray-Pedersen B, Børdahl PE, Frøen JF. Concerns for decreased foetal movements in uncomplicated pregnancies – Increased risk of foetal growth restriction and stillbirths among women being overweight, advanced age or smoking. The Journal of Maternal-Fetal & Neonatal Medicine, October 2010; 23(10): 1129-1135. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.3109/14767050903511578|
|Paper III: Tveit JVH, Saastad E, Stray-Pedersen B, Børdahl PE, Flenady V, Fretts R, Frøen JF. Reduction of late stillbirth with the introduction of fetal movement information and guidelines - a clinical quality improvement. BMC Pregnancy and Childbirth 2010, 10:49. Published under a Creative Commons Attribution License. The published version of this paper is available at: https://doi.org/10.1186/1471-2393-9-32|
|Paper IV: Saastad E, Tveit JVH, Flenady V, Stray-Pedersen B, Fretts R, Børdahl PE, Frøen JF. Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women – a clinical quality improvement. BMC Research Notes 2010, 3:2. Published under a Creative Commons Attribution License. The published version of this paper is available at: https://doi.org/10.1186/1756-0500-3-2|