Repetitive Admissions for Decreased Fetal Movements in Post-Date Pregnancies

The Maternal and Perinatal Health Standards Committee has reviewed several cases of fetal demise in the context of post-date pregnancies, following repeated presentations to the hospital for evaluation of decreased fetal movements.

Normally, assessments include a non-stress test with the patient being discharged after a reactive non-stress test. It is prudent for physicians and maternity health care workers to be alerted as to whether the patient had repeatedly been presenting themselves with the same complaint of decreased fetal movements. In those scenarios, even though the non-stress test may be reactive, consideration should be given to either inducing labour or active arrangements for urgent enhanced fetal and placental wellbeing should be undertaken through fetal biophysical scoring and doppler studies of the placental and umbilical cord flow at a Fetal Assessment unit, if available. In rural settings where a fetal assessment unit is not readily available, induction of labour should be considered.

- The Maternal and Perinatal Health Standards Committee