Outcome of Management of Pregnant Women with Decreased Fetal Movements in a Resource Constrained Setting in Southwest Nigeria

Aims: To evaluate pregnant women with decreased fetal movements (DFM) identifying the risk factors and perinatal outcomes of such pregnancies.

Study Design: A case-control study.

Place and Duration of Study: Department of Obstetrics and Gynecology, Ekiti State University Teaching Hospital, Ado-Ekiti, between April 1 2017 and March 31 2018.

Methodology: Women with singleton pregnancy presenting to the Department with complaint of DFM (cases) after 28 weeks of gestation were recruited and compared with women with no complaint of DFM that delivered in the facility during the study period. Sociodemographic data, obstetric characteristics. Antenatal risk factors, mode of delivery and perinatal outcomes were obtained using a semi-structured questionnaire. Data collected were analyzed with SPSS and variables were compared using student t test and chi square or Fisher exact test while p value was <0.05.

Results: Out of 1439 women in the third trimester during the study period, 117 women had complaint of DFM with a prevalence of 12.3%. There was no statistical difference in the socio-demographic characteristics between the two groups; P>0.05. The mean gestational age at presentation and delivery were significantly lower among women with DFM (31.95 ± 1.81 weeks versus 37.46 ± 2.98 weeks; P=0.001 and 35.05 ± 1.47 weeks versus 37.46 ± 2.98 weeks; P=0.001 respectively). More women with DFM significantly had preeclampsia and intrauterine growth restrictions (P=0.002), oligohydramnios (p=0.016), caesarean delivery (P=0.005) and SCBU admission (P=0.009). The mean birth weight and Apgar scores at 1 minute were significantly lower in women with DFM (2.64 ± 0.54 kg versus 3.25 ± 0.57 kg; P=0.001 and 7.13 ± 0.68 versus 7.42 ± 0.82; P=0.003 respectively).

Conclusion: This study showed that women with DFM are a higher risk of operative delivery and poor perinatal outcome such birth weight and Apgar score. Maternal perception of fetal movements should form part of risk assessment during routine visits.