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Surveillance
Journal Report
Tana, Mobbydick G.
Section D
November 7, 2016
American Journal of Obstetrics and Gynecology
March 2015
Brief Background
Antepartum Fetal Surveillance
Fetal movement counting
Non-stress test
Contraction stress test
Biophysical Score
Brief Background
Reduced Fetal Movements
High risk for stillbirth
Fetal growth restriction
Placental dysfunction
Objective:
To evaluate the association of Reduced fetal
movements (RFM) and small-for-gestational-age (SGA)
fetuses at term.
Methodology
P = Singleton pregnancies
O = association of reduced fetal movement with SGA
M = Retrospective Cohort
Methodology
Data Collection
1st visit General Maternal Data
Pregnancy Dating CRL
Methodology
Data Collection
Routine tests
PAPP-A + Screening for Trisomy 21 11-14 weeks
Uterine artery (UtA) Doppler indices 19 23 weeks
UtA Pulsatility index >90th percentile = growth scan at 28 36
weeks
RFM >28 weeks assessment of fetal well being
Computerized cardiotocography, Fetal biometry, AFV and fetal
doppler
Methodology
Statistical analysis
Logistic Regression analysis
Significant if P-value <0.5
Results and Discussion
To evaluate association of Reduced fetal movements (RFM) and small-
for-gestational-age (SGA). Prevalence Rate
SGA at birth
with RFM = 15.6%
without RFM = 7.3%
SGA
Single episode = 9.8%
Repeated episodes = 44.2%
To evaluate association of Reduced fetal movements (RFM) and small-
for-gestational-age (SGA).
To evaluate association of Reduced fetal movements (RFM) and small-
for-gestational-age (SGA).
Discussion
Fetal movement counting
Hypoxemia = decreased fetal movements
Uterine Artery Doppler = impaired placentation