Compliance with a fetal movement chart by high risk patients

OBJECTIVE:

To compare the degree of compliance with a novel fetal movement chart (FMC) by high risk patients versus the standard ‘‘count-to-ten’’ charting method of fetal activity monitoring.

STUDY DESIGN:

Prospective randomized trial of 1,400 high-risk patients presenting for prenatal care at a single institution between October 1999 and March 2000. Patients with singleton gestations were randomly assigned to use either the ‘‘count-to-ten’’ charting method of fetal activity monitoring or the FMC proposed by the Latin American Center for Perinatology and Human Development (CLAP Group). The FMC records fetal movements during 30 minutes following meals and before bedtime at night; a registry of ten or more movements per day is considered normal. Patients were defined as compliant with the method if they brought a completed chart to all subsequent visits during a minimum follow-up of one month. By means of direct interviews, patients were asked to identify the main advantage and disadvantage (in case of abandonment) of the assigned chart. Compliance with regimens was compared between the 2 groups using chi square tests.

RESULTS:

Demographic characteristics were similar between groups. Sixtyfour percent (448/700) of the FMC group were compliant recording fetal activity compared with 91% (638/700) of the ‘‘count-to-ten’’ group (p < 0.001). Non-interference with daily life activities was the main advantage of using the ‘‘count-to-ten’’ chart. No cases of intrauterine demise occurred in either group and rates of intervention based on either method were similar.

CONCLUSION:

High risk patients were more compliant with the standard ‘‘count-to-ten’’ method of fetal activity monitoring than with the FMC. This easy and cheap technology should not be disregarded in obstetric practice in developing countries.