October 16, 2009

Fetal Kick Charts Are Often Inaccurate

Irish researchers say that fetal kick charts, used to determine if a pregnancy is progressing well, are inaccurate and should be discontinued, BBC News reported.

Some 5 percent of doctors use the charts in the UK, but they are more common in the Republic of Ireland and the U.S.

However, Cork University researchers say the charts rely on the mother's perceptions and may lead to miscounts of a baby's movements and therefore, they recommend checking the fetal heart rate instead.

A reduction of fetal movements causes concern and anxiety for both the mother and her doctor, according to the research published in the journal, The Obstetrician and Gynecologist.

A growing baby should move from 20 weeks into the pregnancy and expectant mothers should then feel some sort of movement every day right up to the birth.

Meanwhile, some 15 percent of pregnancies are assessed in hospitals because the mother is concerned that her baby is not moving well.

The baby could be unwell or have a number of conditions including severe growth restriction, if decreased movement is noticed for more than 24 hours.

The researchers carried out an anonymous online questionnaire of around 100 Irish obstetricians and found that only a third had a clinical practice guideline for dealing with reduced fetal movements.

At least 70 percent of obstetricians have these guidelines in the UK.

Fetal kick charts did not compare well to more modern methods such as measuring the fetal heart rate with a cardiotocograph (CTG) and ultrasound, according to Dr. Julia Unterscheider, who led the research.

"We suggest that a careful history and examination together with a CTG are used to confirm fetal wellbeing. Ultrasound evaluation is recommended when babies are at and beyond their due date, or when examination of the mother's abdomen suggest that the baby is small," Unterscheider said.

She added that kick charts, which are in use in many maternity units worldwide, are of no benefit to reducing poor outcomes in low-risk pregnant women.

"A mother's subjective perception of diminished movements is a better predictor of problems," she noted.

"It is important to monitor the babies movements," said Pat O'Brien of the Royal College of Obstetricians and Gynecologists, who welcomed the study. "It's like an early warning, nine out of 10 times there won't be anything wrong."

He explained that some mothers don't feel the kicks because they're too active. 

"I tell mothers if it gets to the middle of the afternoon and you still can't feel anything, find some place quiet. Sit down and concentrate on the babies' movements. Push the baby around gently and if you are still worried come up to the hospital," he said.


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