Assessment of Fetal Movements as a Simple Monitor of Fetal Well-Being

Original article


S. Rifai, H. Shawer, Eva Sypniewska

Department of Gynaecology and Obstetrics, Faculty of Medicine, Ben ghazi, S.P.L.A . J.

Garyounis Medical Journal Vol. 8, No.1. July 1984:55-60


Decreased fetal movements are seen in cases of chronic fetal distress such as preeclampsia, hypertension in pregnancy, etc. Fetal movements in utero were subjectively assessed in 250 pregnant women. It was shown in this study that, where a pronounced decrease or cessation of fetal movements was observed indicating impending fetal death in utero, the fetal heart was still audible for 12 hours subsequently. This observation we called the “Fetal Alarm Sign” (F.A.S.). This in our opinion is an indication for immediate delivery of the fetus provided the fetus is viable. 250 high risk pregnant women were instructed to record daily fetal movements as a monitor of fetal condition. 40 patients observed the F.A.S. 28 refused delivery and all had stillbirths within 24 hours — 12 were delivered electively, 11 babies survived and one died due to respiratory distress. Further it was shown that in the 12 cases of F.A.S. electively delivered, abnormal fetal heart rate changes appeared only in 51% and Meconium was found in only 60% of cases. These results indicate that a daily fetal movement count by the patient can be used as a good predictive test to monitor fetal well-being in high risk pregnancies in hospital and at home.
This simple self-monitoring assessment has enormous application in our country as an inexpensive and accurate diagnostic test of fetal well-being. Using this method and comparing it to various methods of monitoring we outline our own protocol for diagnosis and management of the deteriorating placenta.

Keywords: Assessment of Fetal Movements as a Simple Monitor of Fetal Well-Being