From the Guidelines
Increased fetal movements in the third trimester are typically a reassuring sign of fetal well-being and normal development, but a sudden, significant increase in fetal movements that feels different from the baby's normal pattern could potentially indicate fetal distress.
Key Points to Consider
- Most healthy babies have periods of increased activity throughout the day, with many pregnant women noticing more movement after meals or in the evening when they are resting 1.
- A sudden, significant increase in fetal movements that feels different from the baby's normal pattern could potentially indicate fetal distress in some cases, such as from a decrease in oxygen supply or placental issues 1.
- The baby may move more vigorously if experiencing stress, and it's essential to become familiar with the baby's normal movement patterns during pregnancy to recognize significant changes.
- Healthcare providers recommend doing daily "kick counts" in the third trimester, typically counting 10 movements within a 2-hour period, to help monitor the baby's well-being 1.
Importance of Monitoring Fetal Movements
- Monitoring fetal movements is crucial in assessing fetal well-being, especially in the third trimester 1.
- A biophysical profile (BPP) can be performed to assess fetal well-being, which includes ultrasound-based assessments of fetal breathing movements, discrete body movements, fetal tone, and amniotic fluid volume 1.
- The BPP can help identify potential issues with fetal development and growth, such as fetal growth restriction (FGR), which can be associated with significant risks of perinatal morbidity and mortality 1.
Next Steps
- If a dramatic change in the baby's movement pattern is noticed, it's essential to contact a healthcare provider promptly for evaluation 1.
- The healthcare provider may recommend monitoring or an ultrasound to check on the baby's condition and assess fetal well-being 1.
- Regular assessment of fetal biometry, evaluation of amniotic fluid volume, and use of the BPP can contribute to the determination of fetal compensation or compromise 1.
From the Research
Increased Fetal Movements in the 3rd Trimester
Increased fetal movements in the 3rd trimester can be an indicator of various factors, including:
- Fetal health and well-being 2, 3
- Fetal compromise or distress 4, 5
- Adverse neonatal outcomes, such as large for gestational age (LGA) 2
- Fetal seizures or umbilical cord entanglement 4
- Maternal anxiety or perception of fetal activity 4, 6
Possible Causes and Associations
Some possible causes and associations of increased fetal movements in the 3rd trimester include:
- Gestational age, particularly over 37 weeks 2
- Previous delivery and vaginal birth rate 2
- Fetal seizures or umbilical cord entanglement 4
- Infection or noxious stimuli 4
- Maternal anxiety or stress 4, 6
- Adverse intrauterine environment 5
Management and Assessment
The management and assessment of increased fetal movements in the 3rd trimester may involve:
- Fetal non-stress test 2
- Cardiotocography and ultrasonography of the fetus and cord 4
- Maternal history and measurement of maternal blood for inflammatory markers or toxins 4
- Assessment of fetal acidaemia or measurement of stress-related factors in umbilical cord blood 4
- Systematic examination of the placenta and cord for signs of hypoxia, infection, or umbilical cord compression 4