Table 1. Management of reported decreased fetal movements.
Study | Intervention A | Subgroup with decreased fetal movements/whole group n/N (%) | Intervention B | Subgroup with decreased fetal movements/whole group n/N (%) | Outcome | Main outcomes for whole group | ||
---|---|---|---|---|---|---|---|---|
Group A | Group B | RR (95% CI) | ||||||
Computerised interpretation | ||||||||
Bracero 1999 | Visual interpretation |
21/205 (10%) | Computerised interpretation |
23/205 (11%) | Perinatal mortality and severe morbidity |
20/201 | 11/204 | 1.85 [0.91 to 3.75] |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
1/201 | 0/204 | 3.04 [0.12 to 74.30] | |||||
Doppler | ||||||||
Burke 1992 | Doppler | 9/241 (4%) | Control | 16/235(7%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
58/241 | 51/235 | 1.11 [0.80 to 1.54] | |||||
Perinatal mortality alone |
4/241 | 3/235 | 1.11 [0.80 to 1.54] | |||||
Hofmeyr 1991 | Doppler | 49/438 (11%) | Fetal heart rate | 65/459 (14%) | Perinatal mortality and severe morbidity |
70/438 | 77/459 | 0.95 [0.71 to 1.28] |
Caesarean section |
107/438 | 123/459 | 0.91 [0.73 to 1.14] | |||||
Perinatal mortality alone |
4/438 | 8/459 | 0.52 [0.16 to 1.73] | |||||
Johnstone 1993 | Doppler group | 157/1114 (14%) | Non-Doppler group | 181/1175 (15%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
170/1114 | 198/1175 | 0.91 [0.75 to 1.09] | |||||
Perinatal mortality alone |
NA | NA | ||||||
Williams 2003 | Doppler group | 147/649 (23%) | Non-stress test group | 162/691 (23%) | Perinatal mortality and severe morbidity |
16/649 | 24/691 | 0.71 [0.38 to 1.32] |
Caesarean section |
183/649 | 223/691 | 0.87 [0.74 to 1.03] | |||||
Perinatal mortality alone |
0/649 | 1/691 | 0.35 [0.01 to 8.70] | |||||
Biophysical profile | ||||||||
Jamal 2007 | Modified biophysical profile | 18/96 (19%) | Biophysical profile | 8/104 (8%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
1/96 | 1/104 | 1.08 [0.07 to 17.08] | |||||
Abnormal test results |
30/96 | 24/104 | 1.52 [0.81 to 2.84] | |||||
Manning 1984 | Biophysical profile scoring group, | 16/375 (4%) | Non-stress testing scheme group | 13/360(4%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
4/375 | 4/360 | 0.96 [0.24 to 3.81] | |||||
Abnormal test result |
23/375 | 61/360 | 0.32 [0.19 to 0.53] | |||||
Sood 2007 | Modified biophysical profile following vibroacoustic stimulation group | 15/110 (14%) | Mock stimulation group | 13/104 (13%) | Perinatal mortality and morbidity |
4/110 | 8/104 | 0.47 [0.15 to 1.52] |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
2/110 | 3/104 | 0.63 [0.11 to 3.70] | |||||
Abnormal test result |
3/110 | 7/104 | 0.41 [0.11 to 1.53] first) | |||||
Acoustic stimulation | ||||||||
Newnham 1990 | Fetal acoustic stimulation group | 17/90 (19%) | Non-stress testing scheme group | 13/82 (16%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
0/90 | 0/82 | Not estimable | |||||
Non-reactive CTG | 17/150* | 25/150* | 0.64 [0.33 to 1.24] | |||||
Sleutel 1990 | Single 5 second vibroacoustic stimulus group | 1/23 (4%) | Intermittent vibroacoustic stimuli group | 5/22 (23%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
NA | NA | ||||||
Smith 1986 | Fetal acoustic stimulation group | 63/366 (17%) | Non-stress test group | 49/349 (14%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
0/366 | 1/349 | 0.32 [0.01 to 7.78] | |||||
Non-reactive test | 78/858* | 122/869* | 0.61 [0.45 to 0.83] | |||||
Tongsong 1994 | Fetal acoustic stimulation group | 128/635 (20%) | Non-stress test group | 129/638 (20%) | Perinatal mortality and severe morbidity |
NA | NA | |
Caesarean section |
NA | NA | ||||||
Perinatal mortality alone |
NA | NA | ||||||
Non-reactive CTG |
43/635* | 88/638* | 0.49 [0.35 to 0.70] |
In May 2011 the lead authors on each of the following trials were contacted regarding the availability of outcomes specifically for cases admitted to the trial with decreased fetal movements. Data for this subgroup were available only for the 28 cases in Sood 2007. The data above refers to the whole sample in each trial.
NB refers to number of tests, not women