Table 3 Impact of fetal movement counting on stillbirth and perinatal mortality
From: Reducing stillbirths: screening and monitoring during pregnancy and labour
Source | Location and Type of Study | Intervention | Stillbirths/Perinatal outcomes |
|---|---|---|---|
Reviews and meta-analyses | |||
Mangesi et al. 2007 [22] | Peru, Denmark. Meta-analysis (Cochrane). 3 RCTs included (N = 66 women). | Routine fetal movement counting (intervention) versus mixed or undefined fetal movement counting (controls). | SBR: weighted mean difference = 0.23 [95% confidence interval (CI): -0.61–1.07) [NS] [Mean (SD) = 2.90 (1.90) vs. 2.67 (1.55) in intervention vs. control groups, respectively]. |
Intervention studies | |||
Gomez et al. 2007 [166] | Peru. Hospital setting. RCT. Pregnant women (N = 1400). | Compared two different charting methods: a novel fetal movement chart proposed by the Latin American Center for Perinatology (CLAP) (intervention) vs. the count-to-ten Cardiff chart method (comparison). | Fetal death (miscarriage+SB): Relative risk (RR) not estimable. [0/700 in both groups]. |
Grant et al. 1989 [28] | UK, USA, Ireland, Sweden, Belgium. Cluster RCT. 66 clusters. Pregnant women (N = 68654 women; N = 31993 intervention, N = 36661 controls). | Compared the impact on birth outcomes of asking mothers to keep routine kick charts (intervention) vs. not keeping kick charts (controls). | Unexplained late antepartum fetal death: 59/31993 (2.9/1000) vs. 58/36661 (2.7/1000) in intervention vs. control groups, respectively [NS]. |
Moore 1989 [27] | USA. Hospital setting. Before-after pilot study (N = 2519 deliveries before intervention, N = 1864 after introduction of intervention.) | Assessed the impact of introducing formal fetal movement assessment (intervention) compared to no monitoring before the intervention (controls). | Fetal death (miscarriage+SB): 2.1/1000 vs. 8.7/1000 after vs. before, respectively. (χ2 = 6.8; P < 0.01) |
Observational studies | |||
De Muylder 1988 [24] | Zimbabwe. Hospital setting. Prospective cohort study. High-risk pregnant women (N = 200). | Compared the obstetrical outcome among the patients with a normal kick chart (unexposed), compared to those with an abnormal count (exposed). | SBR: 19.4% vs. 0.7% in charts that went from normal to being abnormal vs. unexposed. (P < 0.001) PMR: 22.2% vs. 2.7% for previously normal charts that became abnormal vs. unexposed (P < 0.001) |
Lema et al. 1988 [23] | Kenya. Urban hospital setting. Prospective cohort study. High-risk pregnant women (N = 110). | Compared birth outcomes among women with good fetal movements vs. poor fetal movements. | SBR: 12/1000 (1/83) vs 185/1000 (5/27) in the good vs. poor fetal movements group, respectively. No statistical significance data. |
Sinha et al. 2007 [25] | UK. Hospital setting. Retrospective cohort study. N = 180 case reports. | Compared the impact of reduced fetal movements (exposed) to women without reduced fetal movements (unexposed) on PMR. | PMR: RR not estimable. [0/90 in the exposed vs. 0/90 in the control groups, respectively]. Intervention needed solely due to fetal compromise: 29/90 (32%) in the study vs. 19/90 (21%) in the control groups, respectively. |
Romero Gutiérrez et al. 1994 [26] | Mexico. Hospital setting. Prospective cohort study. Pregnant women (N = 200; N = 100 intervention, N = 100 controls) 32–41 wks gestation without risk factors. | Compared the impact of decreased fetal movement (exposed) vs. normal fetal movement (unexposed) on PMR. | PMR: No difference [NS] |