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What causes reduced fetal movement during pregnancy?

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Posted on Thu, 20 Nov 2014
Question: we had a bad experience of still birth a day before the delivery(37-38 week) scheduled in last pregnancy. Post delivery investigations doesn't conclude much & probable reason is expected as placental abruption.
my wife is pregnant again by god grace. & has completed 32 weeks.from last few days she is not realising baby movement what it use to be like 5-6 in an hour post lunch or dinned or at early morning post she wake up.This happen during last pregnancy almost at the same phase.We have done USG & NST & every thing is fine by the reports.But we are still worried & insist the doctor to have a C-Section if required but she is insisting to wait till start of 37th week. We are quite worried & hence required your opinion & suggestion. (Just to mention placental position in high grade II maturity ) & baby heart beat is n between 14-150.
Thanks a lot.
doctor
Answered by Dr. Aarti Abraham (15 minutes later)
Brief Answer:
BETTER NOT DELIVER A PREMATURE BABY

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Well, placental abruption would be proved.
It would show up on a scan, or , if minimal, would be seen when the placenta gets delivered after the baby is born.
Can you upload the latest ultrasound report ?
Also, I think there is a typing error, you must mean a fetal heart rate of 140 - 150, not between 14 - 150.
Also, having a baby delivered at 32 weeks is not a good idea.
The baby would have various complications of prematurity, some of them life threatening, such as immature lungs, immature gut, breathing trouble, metabolic complications etc.
If she is not having good fetal movement, it is best to keep a chart of baby movements.
THis means counting baby movements for one hour each - after breakfast, lunch , and dinner.
Total of all 3 hours should be atleast 10.
If this criteria is not met, please see your doctor.
Have auscultation of baby ' heart, plus ultrasound scan and Colour Doppler.
Tracing of baby's heart beats - called CTG - cardiotocography - should be done, though ideally it should be done after 34 weeks.
If all is well on investigations, it is best to have the baby delivered till atleast after 37 weeks.
I can understand your natural anxiety, but have complete vigilance of your wife ( if required, even daily checkups by the doctor ) and do not subject the baby to risks of prematurity.
I would also like to include a checklist after a stillbirth, hope it was all done, and if not , whatever can be done now , should be done.
1. Complete blood count and blood group.
2. Karyotyping and proper post mortem of the child who was stillborn.
3. Karyotyping of parents.
4. Infections screen.
5. Oral glucose tolerance test, TSH, Thalassemia screen.
6. Screening for antiphospholipid antibodies
Often, unexplained stillbirth is idiopathic ( for no reason ), but atleast this much of workup should be done.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (2 days later)
I am attaching the discharge summary of the IUD happened last time,Recent USG report & NST report for your review & expecting you to just go through the same & conclude on the current status of pregnancy.
doctor
Answered by Dr. Aarti Abraham (34 minutes later)
Brief Answer:
NST IS FINE, DONT WORRY.

Detailed Answer:
I have gone through the attached reports in detail.
The discharge summary of the previous delivery mentions a retroplacental clot, but there is nothing specific about the type and severity of placental abruption.
This time round, I can see that NST was done after she complained of diminished fetal movements, and the NST is fine, so there is nothing to worry.
Was the scan done on 28.10.14 before the decreased movements or afterwards ?
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Aarti Abraham (15 minutes later)
yes the scan was done a day before the NST. Even on the day of scanning or a day before also the fetal movement found less than how it was earlier.
doctor
Answered by Dr. Aarti Abraham (4 minutes later)
Brief Answer:
IT IS NORMAL

Detailed Answer:
The scan is quite normal, I can see nothing to worry about.
Just very vigilant monitoring of fetal movements, and twice a week check ups by your OB - GYN, if not more frequent.
WIsh you lots of luck this time round.
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Dr. Aarti Abraham

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What causes reduced fetal movement during pregnancy?

Brief Answer: BETTER NOT DELIVER A PREMATURE BABY Detailed Answer: Hello Thanks for writing to us with your health concern. Well, placental abruption would be proved. It would show up on a scan, or , if minimal, would be seen when the placenta gets delivered after the baby is born. Can you upload the latest ultrasound report ? Also, I think there is a typing error, you must mean a fetal heart rate of 140 - 150, not between 14 - 150. Also, having a baby delivered at 32 weeks is not a good idea. The baby would have various complications of prematurity, some of them life threatening, such as immature lungs, immature gut, breathing trouble, metabolic complications etc. If she is not having good fetal movement, it is best to keep a chart of baby movements. THis means counting baby movements for one hour each - after breakfast, lunch , and dinner. Total of all 3 hours should be atleast 10. If this criteria is not met, please see your doctor. Have auscultation of baby ' heart, plus ultrasound scan and Colour Doppler. Tracing of baby's heart beats - called CTG - cardiotocography - should be done, though ideally it should be done after 34 weeks. If all is well on investigations, it is best to have the baby delivered till atleast after 37 weeks. I can understand your natural anxiety, but have complete vigilance of your wife ( if required, even daily checkups by the doctor ) and do not subject the baby to risks of prematurity. I would also like to include a checklist after a stillbirth, hope it was all done, and if not , whatever can be done now , should be done. 1. Complete blood count and blood group. 2. Karyotyping and proper post mortem of the child who was stillborn. 3. Karyotyping of parents. 4. Infections screen. 5. Oral glucose tolerance test, TSH, Thalassemia screen. 6. Screening for antiphospholipid antibodies Often, unexplained stillbirth is idiopathic ( for no reason ), but atleast this much of workup should be done. All the best Please feel free to discuss further.