Perinatal Outcome in Women at Term with Reduced Fetal Movements
Objective: To find out the impact of perception of reduced fetal movements on mode of delivery and poor perinatal outcome in pregnant women at term.
Methodology: This was a Descriptive case series. The study was completed in six months from Feb 10th, 2019 till August 10th, 2019 in department of Gynecology and Obstetrics, Unit-II holyfamily hospital Rawalpindi after ethical approval from IRB. Sample size was calculated by WHO calculator. Data was collected for demographics (e.g. name and age), contact details, pregnancy related details (e.g. parity, gestational age). Females meeting inclusion criteria were enrolled through department of Obstetrics and Gynecology, Unit-II holyfamily hospital Rawalpindi. Their detail evaluation and clinical examination was done. They were observed till their outcome. Induction of labor was done if there were no uterine contractions along with decreased fetal movement. C-section was done if there was any indication that was decided by senior gynecologist consultant. Apgar score as per operational definition was calculated at 1st and 5th minutes. All data was collected by researcher herself on prescribed proforma. All data that was collected was entered and then analyzed by using SPSS version 21.0.
Results: The mean age of all cases was 28.16 ± 4.05 with minimum and maximum age as 18 and 35 years. The mean weight, height and BMI was 90.17 ± 17.06 (kg), 1.81 ± 0.17 (m) and 27.44 ± 2.56 respectively. The mean gestational age was 38.88 ± 1.45 weeks with range of 4 weeks (37 to 41 weeks). A total of 109(53.2%) females needed induction of labour, 33(16.1%) had C-section and Apgar score < 7 was noted in 23(11.2%) of the neonates.
Conclusion: We conclude that the frequency of Apgar score < 7 was somehow high in patients those presented with decreased fetal movements. So in future females who present with reduced fetal movement even with no other fetal abnormality, should be managed as being at high risk of placental insufficiency and should be assessed and treated immediately. By preventive and therapeutic strategies we can reduce the related morbidity such as maternal stress, low Apgar score and NICU admission.
Keywords: Pregnancy, Reduced fetal movements, Apgar score, Perinatal outcome, Term
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