Does the utilisation and knowledge of fetal movement counting interventions and ‘kick charts’ enhance maternal awareness of fetal movement patterns and reduce stillbirths in pregnancies ≥28 weeks’ gestation?
Throughout Ireland and internationally, stillbirths represent a significant global issue with 2.6 million cases reported in 2015. Reports demonstrate that approximately 50% of stillbirths are unexplained and are frequently preceded by changes in fetal movement patterns. Fetal activity in-utero is a commonly referenced indicator of fetal wellbeing during pregnancy whereby fetal movement counting methods such as ‘kick-charts’ are utilised to monitor maternal perceptions of fetal movement to identify pregnancies at increased risk of stillbirth. However, variations in fetal movement counting methods and definitions of reduced fetal movement in international literature has led to inconsistencies in the use and perceived importance of ‘kick-charts’. This paper aims to conduct an in-depth evidence-based practice literature review into the correlation between ‘kick-chart’ utilisation and a reduction in stillbirth rates through an analytical appraisal of relevant literature identified through a systematic search strategy. Although a lack of conclusive evidence currently exists to firmly support or refute the routine implementation of fetal movement counting as a measure to reduce stillbirth, indirect evidence demonstrated in this review suggests that increased maternal and professional vigilance and awareness of fetal movements may reduce the risk of stillbirths in singleton pregnancies. Therefore, further research is urgently required to develop an appropriate definition of reduced fetal movements, and to determine the acceptability, feasibility and potential implications of formal fetal movement counting as a diagnostic screening tool to identify fetal compromise and subsequently reduce stillbirths.