Fetal movement count may prevent fetal death as early as 26 weeks

摘要

Sir Although it is not established whether fetal movement counting (FMC) reduces fetal death (1), a Norwegian study (2) found that after introduction of FMC the stillbirth rate fell by 30% in their study population of 46 000 singleton pregnancies and fell by 50% among the 3500 women from that group who reported decreased fetal movement. Then, how early can FMC detect a fetus in jeopardy and possibly save lives? We established a reference value of fetal movement from 22 weeks until term (3). We use FMC for all pregnant women visiting us, with the 26_(0/7) week being the first fill-in week. A pri-miparous woman with an uneventful pregnancy course felt decreased fetal movements on the second day of starting the fill-in, at 26_(1/7) weeks. She visited us the next day, with the chief complaint of decreased fetal movements. Cardiotocography indicated minimal variability without bradycardia or deceleration. We then performed ultrasound, with her lying in a left semi-lateral position, which revealed an appropriate-for-date infant with normal amniotic fluid volume; however, a hypercoiling of the cord was also discovered, with the measured umbilical coiling index being 1.17 coils/cm.