Monitoring fetal movement to reduce risk of stillbirth

Understanding a mother’s and baby’s movements to determine if this could be a predictor of increased risk of stillbirth

Professor Ed Mitchell
University of Auckland

What is the problem and who does it affect?

For every 1000 babies born in New Zealand, tragically, five will be stillborn; born dead after 20 weeks’ gestation. In 2011, 330 babies died as a result of stillbirth, resulting in unimaginable grief for mothers and families.

New Zealand rates of stillbirth are not commensurate with where we should be as a developed nation. There could be multiple reasons behind our disparate rates. However, so little is known as to the mechanisms and risk factors behind stillbirth, mothers often blame themselves for the loss of their child.

Recent research undertaken by Cure Kids Chair of Child Health Research at the University of Auckland, Prof Ed Mitchell, has suggested a link between maternal sleep position and risk of stillbirth; namely, there is an associative risk-reduction when mothers sleep on their left hand side. A larger, multicentre trial is now underway to see if these findings can be repeated, however, a recent 40 per cent drop in rates does suggest that primary care providers and midwives are already imparting the maternal sleeping findings.

 

What is this research hoping to achieve?

Another association highlighted in the literature is that between a reduction in fetal movement and an increase in stillbirth rates. Mothers are encouraged to count the number of kicks their baby makes. This method has been shown to be inaccurate in determining the movement of the fetus as it can often be indistinguishable from a mother’s movement.

Prof Mitchell and his team are trialling a piece of software which isolates the movement of the fetus from that of the mother with the hope that it could be a predictor of increased risk of stillbirth and other perinatal outcomes.

Mothers undergoing assessment in the Day Ward or inpatients in the last trimester of pregnancy will lay at rest of an hour, pressing a button when they feel they’ve felt a movement from the fetus. The fetal movement activity monitor (FMAM) will contemporaneously measure their movements.

The results will be compared, looking for any differences between the mother’s reporting of kick-count versus that of the FMAM.

An objective measure of fetal movement could likely overcome many of the shortcomings of the conventional, kick-count method, with the desired outcome being a greater understanding of risk factors for stillbirth which can be addressed before the event.