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A more recent review agrees with your general summary: "Evidende is lacking that monitoring fetal movement is an effective independent surveillance technique for predicting fetal growth, malformation and stillbirth". Velazquez MD, Rayburn WF. Antenatal evaluation of the fetus using fetal movement monitoring. Clinical Obstetrics & Gynecology 2002;45(4):993-1004. It bothers me that we routinely teach this to midwife students as a helpful tool, and they routinely teach it to patients, when it is not evidence based, as far as I can tell. Jeanne Raisler --On Thursday, January 23, 2003 6:51 PM +0000 Hora Soltani <[log in to unmask]> wrote: > 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 > > > > ********************************DISCLAIMER******************************** > This email and any files transmitted with it are confidential and > intended solely for the use of the individual or entity to whom they > are addressed. However, any views or options presented are > solely those of the author and do not necessarily represent those > of the Southern Derbyshire Acute Hospitals NHS Trust. If you are > not the intended recipient or the person responsible for delivering > the email to the intended recipient, be advised that you have > received the email in error and that any use, dissemination, > forwarding, printing or copying of this email is strictly prohibited. > SDAHTwill not be liable for direct, special, indirect or consequential > damages arising from alterations of the contents of this message > by a third party or as a result of any virus being passed on. > > If you have received this email in error please contact the SDAHT > administrator. Email or telephone on 44 (0)1332 340131 ext 5777 > ************************************************************************* > ****** [log in to unmask]