Do fetal kick counts reduce the risk of stillbirth?

From the Guidelines

Fetal kick counts are not a proven method to reduce the risk of stillbirth, as there is limited evidence to support their effectiveness in preventing fetal death. The American College of Radiology Appropriateness Criteria suggest that antenatal fetal testing is not recommended in low-risk pregnancies, and that women with high-risk factors for stillbirth should undergo antenatal fetal surveillance 1. Daily monitoring of fetal movements can help mothers recognize changes in their baby's normal pattern of activity, but there is no conclusive evidence that this reduces the risk of stillbirth.

Key Points to Consider

• Antenatal fetal testing is not recommended in low-risk pregnancies 1
• Women with high-risk factors for stillbirth should undergo antenatal fetal surveillance 1
• No single antenatal test has been shown to be superior; all have high negative predictive values 1
• The optimal interval of testing is unknown; weekly or twice-weekly testing has become the standard practice in high-risk pregnancies 1

Recommendations for Clinical Practice

• Pregnant women with high-risk factors for stillbirth should undergo antenatal fetal surveillance, as recommended by the American College of Radiology Appropriateness Criteria 1
• Fetal kick counts can be used as a method for mothers to monitor their baby's well-being, but it is essential to note that there is limited evidence to support their effectiveness in preventing fetal death
• Healthcare providers should recommend performing kick counts at the same time each day, preferably when the baby is typically active, such as after meals
• If a mother notices fewer than 10 movements in a 2-hour period, or a significant change in the baby's movement pattern, she should contact her healthcare provider promptly 1

From the Research

Fetal Kick Counts and Stillbirth Reduction

• Fetal kick counts have been proposed as a method to reduce the risk of stillbirth by monitoring fetal movement and identifying potential complications early on 2, 3.
• Studies have shown that a reduction in fetal movements is associated with fetal hypoxia, increased incidence of stillbirth, and fetal growth restriction (FGR) 2.
• Maternal perception of fetal movements is widely used as a marker of fetal viability and well-being, and a decrease in perinatal mortality has been observed in studies where maternal awareness of fetal movements was raised 2, 3.
• The use of fetal movement counting has been shown to reduce stillbirth rates, particularly stillbirths deemed avoidable, by increasing vigilance towards maternal perception of movements 3.

Effectiveness of Fetal Kick Counts

• A study found that daily fetal movement monitoring has the potential to identify pregnancies at risk, allowing for early intervention and potentially reducing the risk of stillbirth 4.
• Another study demonstrated that fetal movement counting may improve timely identification of decreased fetal activity, contributing to the prevention of adverse pregnancy outcomes 5.
• The effectiveness of fetal kick counts in reducing stillbirth rates is supported by several studies, which suggest that increased awareness and monitoring of fetal movements can lead to better pregnancy outcomes 2, 3, 5.

Implementation and Benefits

• Standardized education and resources, such as the Count the Kicks program, can provide expectant parents with the tools and knowledge to effectively monitor fetal movements and identify potential complications 4.
• Fetal movement counting can be a cheap and effective method of screening for good fetal well-being, particularly in places where more advanced monitoring techniques are not readily available 6.
• The use of fetal kick counts has been shown to be beneficial in reducing stillbirth rates, and further research is needed to optimize its benefits and determine the most effective methods of implementation 2, 3.