Patel Sohini, Conway Alexandra E, Adjei Tricia, Abati Isabella, Dhawan Saksham, Yu Zhenhua, Vaidyanathan Ravi, Lees Christoph
Institute of Reproductive Developmental Biology, Department of Metabolism Digestion and Reproduction, Hammersmith Campus, Imperial College London, London, W12 0HS, United Kingdom.
Barts and The London School of Medicine and Dentistry, Garrod Building, Turner St, London E1 2AD, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2025 Feb;305:329-338. doi: 10.1016/j.ejogrb.2024.12.011. Epub 2024 Dec 12.
Stillbirth is often preceded by reduced fetal movements and obstetric intervention is necessitated for stillbirth prevention. Yet, despite fetal movements being one of the few tangible ways a pregnant woman and the clinical team can assess the wellbeing of her baby, there are few validated, objective means for pregnant women to quantify the frequency and nature of an unborn baby's movements. Traditional methods of assessing fetal wellbeing such as cardiotocography and fetal movement charts have a lack of diagnostic accuracy, and often lead to false positive intervention. The need for fetal movement counting has led to the development of objective methods to attempt to quantify movements. Some are based on electrocardiography, others on the principles of accelerometery, phonography and optical fibre technology. This review paper not only explores these technologies and evaluates the state-of the-art fetal movement monitoring, but explains the engineering principles underpinning the various technologies, and explores the importance and practice of fetal movement monitoring. To this end, we conclude that there is still a need for the continued development of innovations which will enable a pregnant woman to carry out everyday activities, whilst confident in the knowledge that her unborn child's wellbeing is being accurately monitored, and that feedback from the monitoring device is readily accessible to her.
死产之前通常会出现胎动减少的情况,因此需要进行产科干预以预防死产。然而,尽管胎动是孕妇和临床团队评估胎儿健康状况的少数切实可行的方法之一,但对于孕妇来说,几乎没有经过验证的客观方法来量化未出生胎儿胎动的频率和性质。传统的评估胎儿健康状况的方法,如胎心监护和胎动图表,缺乏诊断准确性,并且常常导致假阳性干预。对胎动计数的需求促使人们开发客观方法来试图量化胎动。有些方法基于心电图,其他方法基于加速度计、声学记录和光纤技术的原理。这篇综述文章不仅探讨了这些技术,评估了最先进的胎动监测情况,还解释了支撑各种技术的工程原理,并探讨了胎动监测的重要性和实践。为此,我们得出结论,仍然需要持续开发创新技术,使孕妇能够在进行日常活动的同时,确信未出生胎儿的健康状况正在得到准确监测,并且能够方便地获取监测设备的反馈信息。