Fetal kick charts ‘unreliable’ and should be discontinued

October 17, 2009 by Shawn Douglas
Filed under: News, Pregnancy

Fetal kick charts have been used since the 1970s, but new research finds they ‘are of no benefit to reducing poor outcomes in low-risk pregnant women.’

Research published in the journal The Obstetrician and Gynaecologist suggests that mothers rely on fetal heart rate and routine examinations with a doctor rather than depend on fetal kick charts.

Researchers from the Cork University College Maternity Hospital conducted an anonymous survey of nearly 100 Irish obstetricians and found that only one third of them had any real clinical guidelines on the reduction of fetal movement in pregnant women. In comparison, nearly 70 percent of obstetricians in the U.K. had guidelines in place.

The researchers claimed that inaccuracies in counting from unreliable perceptions by the mother could create situations of unnecessary stress for not only the mother, but also for the doctor. Nearly 15 percent of pregnant women seek consultation in the hospital due to concerns that the baby’s movements are irregular.

“The use of these kick charts has now been superseded by the use of more advanced and reliable medical technology, such as ultrasound scans,” said Cathy Warwick, general secretary of the Royal College of Midwives.

University of Cork’s Dr. Julia Unterscheider agrees.

“Unnecessary investigation in an otherwise healthy pregnancy can lead to increased intervention such as caesarean delivery. In contrast, reduced fetal movements can represent a warning sign that the baby is small for gestation or unwell,” said Unterscheider.

“We suggest that a careful history and examination together with a CTG (cardiotocograph) are used to confirm fetal wellbeing at a given time. Ultrasound evaluation is recommended when babies are at and beyond their due date, or when examination of the mother’s abdomen suggests 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, suggested that when a mother has uncertainty about diminished movement, it’s important to focus.

“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.”