%0 Journal Article
%T Reduction of late stillbirth with the introduction of fetal movement information and guidelines ¨C a clinical quality improvement
%A Julie Tveit
%A Eli Saastad
%A Babill Stray-Pedersen
%A Per E B£¿rdahl
%A Vicki Flenady
%A Ruth Fretts
%A J Frederik Fr£¿en
%J BMC Pregnancy and Childbirth
%D 2009
%I BioMed Central
%R 10.1186/1471-2393-9-32
%X All singleton third trimester pregnancies presenting with a perception of DFM were registered, and outcomes collected independently at all 14 hospitals. The quality assessment period included April 2005 through October 2005, and the two interventions were implemented from November 2005 through March 2007. The baseline versus intervention cohorts included: 19,407 versus 46,143 births and 1215 versus 3038 women with DFM, respectively.Reports of DFM did not increase during the intervention. The stillbirth rate among women with DFM fell during the intervention: 4.2% vs. 2.4%, (OR 0.51 95% CI 0.32¨C0.81), and 3.0/1000 versus 2.0/1000 in the overall study population (OR 0.67 95% CI 0.48¨C0.93). There was no increase in the rates of preterm births, fetal growth restriction, transfers to neonatal care or severe neonatal depression among women with DFM during the intervention. The use of ultrasound in management increased, while additional follow up visits and admissions for induction were reduced.Improved management of DFM and uniform information to women is associated with fewer stillbirths.Maternal perception of fetal movements (FM) is a universally implemented self-screening, administered and interpreted individually by all pregnant women, with or without guidance from health care professionals [1]. Maternal reporting of decreased fetal movements (DFM) is a frequent reason for unplanned health consultations through the third trimester ranging between 4%¨C16% in various populations [1-3] and 5% in a previous report [2]. Pregnancies affected by DFM are at increased risk of adverse outcome such as fetal growth restriction (FGR), preterm birth and fetal death [4-9].There is no universally accepted methodology for assessing DFM. Every method has its limitations and a "gold standard" is difficult to define. Maternal perception of FM arises first and foremost as a result of pressure against body-wall structures, and thus the mother's perception reflects gross FM or limb movements
%U http://www.biomedcentral.com/1471-2393/9/32