From the Guidelines
If you notice a decrease in fetal movement towards the end of pregnancy, contact your healthcare provider immediately or go to the hospital for evaluation, as decreased fetal movement can sometimes indicate potential problems with the placenta or umbilical cord that might be reducing oxygen to the baby 1.
Importance of Fetal Movement Monitoring
The standard recommendation is to perform kick counts daily in the third trimester by counting how long it takes to feel 10 movements - this should occur within 2 hours, though often happens much faster.
- If you notice significantly fewer movements than usual, or it takes longer than 2 hours to feel 10 movements, medical attention is needed right away.
- At the hospital, providers will monitor the baby's heart rate and movements using electronic fetal monitoring, and may perform an ultrasound to check amniotic fluid levels and fetal well-being.
- While decreased movement doesn't always mean something is wrong, it's an important warning sign that shouldn't be ignored, as prompt intervention can prevent serious complications including stillbirth 1.
Clinical Guidelines and Recommendations
According to clinical guidelines, mothers with gestational diabetes mellitus (GDM) should be taught to monitor fetal movements during the last 8–10 weeks of pregnancy and to report immediately any reduction in the perception of fetal movements 1.
- Although the optimal application of more intensive fetal monitoring is not well established, it is reasonable to intensify fetal surveillance when pregnancy is allowed to continue beyond 40 weeks’ gestation.
- The American College of Radiology recommends that antenatal fetal surveillance be initiated at 32 to 34 weeks’ gestation for patients at risk, but the timing should be individualized based on the indication for testing, gestational age, and likelihood of neonatal survival 1.
Key Takeaways
- Decreased fetal movement is a significant warning sign that requires immediate medical attention.
- Prompt intervention can prevent serious complications, including stillbirth.
- Regular kick counts and fetal movement monitoring are essential in the third trimester, especially for high-risk pregnancies.
From the Research
Fetal Movement Towards the End of Pregnancy
- Fetal movements can feel weaker towards the end of pregnancy due to various factors, but there is limited direct research on this specific topic.
- Studies have focused on antenatal fetal assessment methods, such as the nonstress test, biophysical profile, and contraction stress test, to evaluate fetal well-being 2, 3, 4, 5.
- A study from 2022 found that the nonstress test can be a useful predictor of maternal and fetal outcome in patients presenting with reduced fetal movement at term 6.
- The biophysical profile, which includes an assessment of fetal movements, has been shown to be a reliable method for evaluating fetal well-being 3, 5.
- It is essential to note that a decrease in fetal movement can be a cause for concern, and pregnant individuals should consult their healthcare provider if they notice any changes in fetal activity.
Antenatal Fetal Assessment Methods
- The nonstress test is a common method used to assess fetal well-being, particularly in high-risk pregnancies 2, 6, 4.
- The biophysical profile is a more comprehensive assessment that includes the nonstress test, as well as evaluations of fetal breathing movements, tone, and amniotic fluid volume 3, 5.
- Contraction stress testing is another method used to assess fetal well-being, although it is not as commonly used due to its labor-intensive requirements and contraindications 2, 4.
Clinical Implications
- Pregnant individuals who notice a decrease in fetal movement should consult their healthcare provider, as this can be a sign of fetal distress or other complications 6.
- Healthcare providers may use antenatal fetal assessment methods, such as the nonstress test or biophysical profile, to evaluate fetal well-being and determine the best course of action 2, 3, 4, 5.