An evaluation of the importance of formal, maternal fetal movement counting as a measure of fetal well-being.

Maternal perception of fetal movements has, over the years, become recognised as a valuable tool for early detection of fetal compromise. Several studies published in the mid-1970s have demonstrated that a reduction or cessation in maternally perceived fetal movements may precede antepartum late fetal death by a day or longer. From these findings formal fetal movement counting emerged as a valuable, non-invasive method of assessing fetal well-being; the belief being that clinical actions taken on the basis of reduced fetal movement counting may prevent antepartum death or morbidity. Conversely, more recent studies have failed to demonstrate that there is a beneficial effect of a formal, fetal movement counting policy on antepartum death. It is not disputed that fetal movements are of clinical importance but it seems that routine daily counting of fetal movements by women followed by appropriate action when movements are reduced offers no advantages over formal inquiry about fetal movements during standard antenatal care. Thus, the application of formal, maternal fetal movement counting as a method of fetal surveillance to reduce late antepartum death must be questioned.