Page last updated at 00:33 GMT, Friday, 16 October 2009 01:33 UK

Foetal kick charts 'inaccurate'

Pregnant woman
A pregnant woman should feel her baby move every day

Foetal kick charts, used to determine if a pregnancy is progressing well, are inaccurate and should be discontinued, according to Irish researchers.

The charts are used by around 5% of doctors in the UK but are more common in the Republic of Ireland and the US.

Researchers from Cork University say the charts rely on the mother's perceptions and may lead to miscounts of a baby's movements.

They recommend checking the foetal heart rate instead.


The research published in the journal, The Obstetrician and Gynaecologist, says a reduction of foetal movements causes concern and anxiety for both the mother and her doctor.

Foetal death
Foetal sleep
Foetal anaemia
Failure of placenta
Increased maternal weight
Location of placenta
A busy mother who is not concentrating on foetal activity

Mothers usually report feeling the baby move from 20 weeks into the pregnancy and should then feel some sort of movement every day right up to the birth.

Around 15% of pregnancies are assessed in hospitals because the mother is concerned that her baby is not moving well.

Decreased movements for more than 24 hours could indicate that the baby is unwell or has a number of conditions including severe growth restriction.

Lack of guidelines

The researchers from Cork University College Maternity Hospital carried out an anonymous online questionnaire of around 100 Irish obstetricians and found that only a third had a clinical practice guideline for dealing with reduced foetal movements.

In the UK, 70% of obstetricians have these guidelines.

Dr Julia Unterscheider, who led the research, said foetal kick charts did not compare well to more modern methods such as measuring the foetal heart rate with a cardiotocograph (CTG) and ultrasound.

She said: "We suggest that a careful history and examination together with a CTG are used to confirm foetal wellbeing.

"Ultrasound evaluation is recommended when babies are at and beyond their due date, or when examination of the mother's abdomen suggest that the baby is small.

"Kick charts, which are in use in many maternity units worldwide, are of no benefit to reducing poor outcomes in low-risk pregnant women - a mother's subjective perception of diminished movements is a better predictor of problems."

Pat O'Brien, of the Royal College of Obstetricians and Gynaecologists, welcomed the study and said it was important to monitor the babies movements: "It's like an early warning, nine out of 10 times there won't be anything wrong."

He said: "You sometimes can't feel them because you are too active and I tell mothers if it gets to the middle of the afternoon and you still can't feel anything, find some place quiet.

"Sit down and concentrate on the babies' movements.

"Push the baby around gently and if you are still worried come up to the hospital.

"Don't tell yourself to sleep on it and see what it's like in the morning - come straight up."

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