British Journal of Obstetrics and Gynaecology Vol 84 No. 8




C. WOOD,Professor and Chairman W. A. W. WALTERS, Associate Professor AND

P. TRIGG,Professional OfJicer Department of Obstetrics and Gynaecology, Monash University Queen Victoria Memorial Hospital, Melbourne, Australia Summary Patient, observer and instrumental methods for recording fetal movements are described. Significant correlations between both patient and observer, and patient and instrumental fetal movement counts, were found. Significant diurnal, daily and weekly variation in fetal movement counts occurred which need to be considered in the interpretation of the frequency of fetal movements as an indication of fetal welfare.

and fetal body and limb movements; and the general complexity of data analysis. Sadovsky et a1 (1973) found a good correlation between fetal movements recorded by an electromagnetic apparatus placed on the maternal anterior abdominal wall and the maternal sensation of movements. This stimulated us to compare several systems for the monitoring of fetal movements.

IT has been suggested, but not proved, that excessive or diminishing fetal movements, especially during the last trimester of pregnancy, may indicate that the fetus is at risk. In the last five years, interest in fetal movement as a clinical sign has been stimulated by the work of Sadovsky and Yaffe (1973) who have shown that when pregnant women record fetal movements, changes in the pattern of movements can help to predict fetal death. Similarly, Pearson and Weaver (1976) found that a low daily fetal movement count by patients was associated with a high incidence of fetal asphyxia. There are a number of problems associated with the methods used for recording fetal movement: the variable reliability of patients as observers; the difficulties posed by sampling during any 24-hour period; the difficulties of recording intensity as well as frequency of movements; the need for simple recording devices ;the need to distinguish between thoracic ‘respiratory’ movements (Ahlfeld, 1905; Boddy and Robinson, 1971; Tremewan et al, 1976)

METHODS Measurement of fetal movements by patients Patients attending the antenatal clinic were asked to volunteer for this study. While some of them had normal pregnancies, others had the various complications listed in Table I. Patients were asked to record fetal movements for three periods of 20 minutes each day from 32 weeks gestation onwards. The three daily recording periods were arbitrarily selected to include the early, middle and late phases of each day: patients counted fetal movements after waking and before getting out of bed, after the midday meal, and 561




TABLE I Number of fetal movements per session during the 36th week of gestation in I I patients ~~



Complications of pregnancy

Mode of delivery



Elective Cs*


Low maternal urinary oestriol


Fetal movement count per session during 36th week of gestation

Apgar score



‘t’ value between sessions 1 vs 2 2 vs 3 1 vs3



1 2 3

9.29 13.71 15.29

3.86 11.25 8.08

2.473 0.708 4.380

Methods of recording fetal movement.

British Journal of Obstetrics and Gynaecology Vol 84 No. 8 NEW SERIES AUGUST 1977 METHODS OF RECORDING FETAL MOVEMENT BY C. WOOD,Professor and Cha...
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