Assessment of reduced fetal movements with cardiotocography

Cardiotocography (CTG) is used commonly to investigate reduced fetal activity in late pregnancy. This study investigates the utility of this strategy in a UK district hospital. The casenotes of 705 pregnancies investigated for reduced fetal movement between January 1997 and September 2000 were reviewed. Intrauterine fetal death was diagnosed in 23 cases (3.3% of attendees); none had presented previously with reduced movements; 844 CTGs were performed in the remaining 682 pregnancies. Seventeen per cent of women presented on more than one occasion. Labour was induced immediately in 10 cases (1.5% of attendees), resulting in one caesarean delivery of a baby with fetal acidosis (the mother was a diabetic) and nine vaginal deliveries of babies with normal Apgar scores (> 6 at 5 minutes). There were no immediate caesarean deliveries without induction. When compared to a control group, labour was induced significantly more often following reduced fetal movements, mostly days or weeks follow the CTG assessment. Operative delivery rates were not significantly different.