Monitoring fetal movement has been used as a means of assessing fetal well-being for well over a century. Several studies have demonstrated a correlation between a perceived decrease in fetal movement and poor perinatal outcome. Many studies have attempted to define the minimum number of fetal movements over a set amount of time varying from minutes to several hours. What is the average number of movements that mothers detect?

Purpose: This is an observational study designed to determine the average number of fetal movements perceived by women presenting for routine antenatal testing. In addition, this study will investigate whether there is a correlation between fetal movements and gestation and amniotic fluid volumes.

Methods: All women presenting to the University of Michigan Perinatal Assessment Center for antenatal testing were asked to indicate each movement perceived while undergoing electronic fetal heart rate monitoring. The number of counts were recorded during the initial 10, 20, and 30 minute intervals of testing. Patient data including age, gravity, parity, gestation age, amniotic fluid volumes, biophysical profile data, indication for testing, as well as movement counts were collected using the WatchChild prenatal record.

Results: 841 patient encounters were reviewed. Indications for testing included: decreased fetal movement, history of a previous IUFD, history of preeclampsia, diabetes, IUGR, post dates testing, preeclampsia, multiple gestations, polyhydramnios, oligohydramios, presentation for prostaglandin gel placement, autoimmune disorders, and PPROM. Data was collected from women from gestational ages of 26 – 42 weeks. The average number of movements recorded in a 10 minute interval was 7 + 9, with a range of 0 – 99. The average number of movements recorded in a 20 minute interval was 15 + 16, with a range of 0 – 139. Two patients with a normal number of fetal movements later presented with an intrauterine demise.

Conclusion: The average number of fetal movements detected by women is higher than those numbers traditionally considered to be reassuring. In addition, there is large variability in the number of movements felt over each time interval. There is a statistically significant negative correlation between fetal movements and gestational age. There is no statistically significant correlation between fetal movements and amniotic fluid volumes.

Future Plans - Dr. Marzano will remain at the University of Michigan as a faculty member in the Women's Health Division.