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BackgroundWe aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes.MethodsWe enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes.ResultsWomen with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks.ConclusionIncreased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

Many studies have reported on the association of reduced fetal movements and stillbirth, but little is known about excessive fetal movements and adverse pregnancy outcome. First described in 1977, sudden excessive fetal movement was noted to reflect acute fetal distress and subsequent fetal demise. Subsequently, little was reported regarding this phenomenon until 2012. However, emerging data suggest that 10-30% of the women that subsequently suffer a stillbirth describe a single episode of excessive fetal movement prior to fetal demise. These episodes are poorly understood but may reflect fetal seizure activity secondary to fetal asphyxia, cord entanglement or an adverse intrauterine environment. At present, the challenge in managing women with excessive fetal movements is a timely assessment of the fetus to identify those women at risk of adverse fetal outcomes who may benefit from intervention.

Objective: To evaluate the association between increased fetal movements during prenatal treatment with acupuncture and the duration of labor in order to distinguish between responders and non-responders. Design: Case-control study. Setting: Department of Obstetrics and Gynecology, Vienna, Austria. Subjects: Group A consisted of 192 women with increased fetal movements during acupuncture (AP); group B consisted of 76 women with no reaction. During each treatment session, fetal movements were noted by the women with a visual analogue scale. Positive response to AP-treatment was registered when at least three times during four treatment sessions an increased fetal movement was noted. Results: Median duration of the first stage of labor was 204 min (range 40–495) in group A and 321 min (range 90–685) in group B (P < 0.0001). Median duration of the second stage of labor was 53 min (range 19–165) in group A and 88 minutes (range 10–259) in group B (P < 0.0001). Conclusion: Our study indicates that increased fetal movements could be a marker for successful prenatal treatment with acupuncture.