Fetal movement counts

Monitoring fetal movement serves as an indirect measure of central nervous system integrity and function. The coordination of whole body movement in the fetus, which requires complex neurologic control, is similar to the coordination of movement in the preterm newborn infant. Short-term observations of the fetus are best performed using real-time ultrasound imaging or Doppler ultrasound. Daily fetal kick counting by the compliant gravida is a worthwhile adjunct in determining the need for fetal surveillance tests in the office and in predicting abnormal FHR patters and perhaps impending stillbirth. Monitoring has its greatest value when placental insufficiency is long-standing; its routine role in low-risk pregnancies requires further clinical investigation. The presence of a vigorous fetus is reassuring. Perceived inactivity requires a reassessment of any underlying antepartum complication and a more precise evaluation by FHR testing or real-time ultrasonography before delivery is considered.