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Dear All
I am asked to look at the evidence around "routine fetal movement counting".  One of my colleagues and I have done a quick lit search and come up with a summary which I include in the bottom of this message (not being allowed to put attachments)!  I will appreciate your views on this/ any other evidence for either side of the argument.
Cheers
Hora

Literature Review - Routine Fetal Movement Counting (Summary)

The purpose of this review is mainly to investigate the use of routine fetal movement counting.  Available research articles were examined by two reviewers and the results are summarised below.  In brief, current available evidence does not support the use of routine fetal movement counting.  

·     There are currently four proposed methods of counting with varying degrees of validation: Fixed count number, fixed time period, individual count number, and counting movement clusters.  The most commonly used method is to ask the mother to record on a chart each day, the time at which she has noticed 10 kicks.  There is little or no robust evidence to prove superiority of any of the above methods over the other.
	
·     The success of any of these methods is reliant on the motivation and compliance of the mother as well as their understanding of the system they are using.


·     Available studies show no improved outcomes for routine counting. The largest of these is the study by Grant, Elbourne, Valentin & Alexander (1989), which had a sample size of over 68,000 women.  This randomised controlled study did not show any significant reduction in the perinatal  mortality in the group who had routine fetal movement counting. 

·     The introduction of routine counting may have significant resource implications for the women who are required to spend time every day counting fetal movements, and attending hospital when the movements are reduced; for the midwifery staff, in teaching women how to use the counting method; and for medical staff assessing the increased number of hospital admissions for decreased fetal movements.  It also increases interventional deliveries.


·     Once a woman has attended medical care with decreased fetal movements, appropriate and timely assessment and intervention (if appropriate) are essential. 


Dr Hora Soltani
Lead Research Midwife
Derby City General Hospital
Tel: 01332 340131, ext. 5134



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