[To evaluate the role of fetal movement counting and amnioscopy in the management of prolonged pregnancies]

Abstract

Objectives: To evaluate the role of fetal movement counting and amnioscopy in the management of prolonged pregnancies.

Materials and methods: PubMed and the Cochrane library were searched using terms: fetal movement counting, decreased fetal movement, post-term pregnancy, late pregnancy, prolonged pregnancy, postdate pregnancy, amnioscopy, meconium amniotic fluid, surveillance of the fetus.

Results: Decreased fetal mouvements (DFM) in prolonged pregnancies is a frequent cause of unplanned visits. For many authors, the best criterion is the self-perception of reduced maternal or any change of fetal movement. Current data is insufficient to show a link between DFM and increased fetal morbidity and mortality. It is reasonable to recommend to the patient to consult in case of DFM and make an assessment of fetal vitality (experts' opinion). Current data are insufficient to show a potential benefit of the establishment of an information given to patients on DFM in prolonged pregnancy (experts' opinion). No fetal movement counting was assessed in the prolonged pregnancy. High negative predictive value of amnioscopy explains it is reassuring only if the amniotic fluid is clear. Amnioscopy showed no neonatal benefit in the survey of prolonged pregnancies (NP4).

Conclusion: In the prolonged pregnancies, no fetal movement counting can reduce the perinatal morbidity and mortality rate. The interest of amnioscopy in the survey of prolonged pregnancies has never been showed. It is not recommended to use it.