Sophiahemmet University, Stockholm, Sweden.
Department of Women and Children´s Health, Karolinska Institute, Stockholm, Sweden.
PLoS One. 2019 May 2;14(5):e0216216. doi: 10.1371/journal.pone.0216216. eCollection 2019.
Women's awareness of fetal movements is important as perception of decreased fetal movements can be a sign of a compromised fetus. We aimed to study rate of labor induction in relation to number of times women seek care due to decreased or altered fetal movements during their pregnancy compared to women not seeking such care. Further, we investigated the indication of induction.
A prospective population-based cohort study including all obstetric clinics in Stockholm, Sweden. Questionnaires were distributed to women who sought care due to decreased or altered fetal movements ≥ 28 week's gestation in 2014, women for whom an examination did not indicate a compromised fetus that required induction of labor or cesarean section when they sought care. Women who gave birth at ≥ 28 weeks' gestation in 2014 in Stockholm comprises the reference group.
Labor was induced more often among the 2683 women who had sought care due to decreased or altered fetal movements (RR 1.4, 95% CI 1.3-1.5). In women who presented with decreased or altered fetal movements induction of labor occurred more frequently for fetal indication than those with induction of labor and no prior fetal movement presentation (RR 1.6, 95% CI 1.4-1.8). The rate of induction increased with number of times a woman sought care, RR 1.3 for single presentation to 3.2 for five or more.
We studied women seeking care for decreased or altered fetal movements and for whom pregnancy was not terminated with induction or caesarean section. Subsequent (median 20 days), induction of labor and induction for fetal indications were more frequent in this group compared to the group of women with no fetal movement presentations. Among women seeking care for altered or decreased fetal movements, the likelihood of induction of labor increased with frequency of presentation.
女性对胎儿运动的感知很重要，因为感知到胎儿运动减少可能是胎儿受损的迹象。我们旨在研究与因胎儿运动减少或改变而寻求医疗护理的女性相比，因这些情况而寻求医疗护理的女性的分娩诱导率。此外，我们还研究了诱导分娩的指征。
这是一项前瞻性的基于人群的队列研究，包括瑞典斯德哥尔摩的所有产科诊所。2014 年，向因妊娠 28 周及以上胎儿运动减少或改变而寻求医疗护理的女性以及因检查未显示需要诱导分娩或剖宫产以保护胎儿而寻求医疗护理的女性发放问卷。2014 年在斯德哥尔摩分娩且妊娠≥28 周的女性构成对照组。
因胎儿运动减少或改变而寻求医疗护理的 2683 名女性中，更多人接受了诱导分娩（RR 1.4，95%CI 1.3-1.5）。在因胎儿运动减少或改变而就诊的女性中，与因无胎儿运动就诊且未行诱导分娩的女性相比，因胎儿原因而进行诱导分娩的情况更为常见（RR 1.6，95%CI 1.4-1.8）。随着女性就诊次数的增加，诱导分娩的比例也随之增加，RR 1.3（单次就诊）至 3.2（就诊 5 次或以上）。
我们研究了因胎儿运动减少或改变而就诊且未因诱导分娩或剖宫产而终止妊娠的女性。与无胎儿运动就诊的女性相比，在这些女性中，随后（中位时间为 20 天）因胎儿原因行诱导分娩和行诱导分娩的比例更高。在因改变或减少胎儿运动而寻求医疗护理的女性中，因胎儿运动减少或改变而就诊的频率越高，行诱导分娩的可能性就越大。
