REFERENCE CURVES FOR THE FETAL MOVEMENT PROFILE - PURPOSE

Purpose: The fetal movement profile (FMP) is often used as an addition al tool for FHR interpretation. Aim of this study was to establish ref erence curves for the FMP dependent on gestational age and to evaluate a ''cut off'' value for the selection of pregnancies at risk. Method and Material: 250 normal pregnancies and 56 high-risk pregnancies with IUGR (birthweight < 5(th) perc.) were investigated between 28(th) and 42(nd) week of gestation using the FMP every 8-10 days. Fetal motor a ctivity was analyzed quantitatively. The diagnostic value of FMP was e valuated with respect to fetal outcome parameters. Results: Fetal moto r activity showed a peak at 35(th) week of gestation. With respect to ROC diagrams the cut off value for the selection of fetuses at risk wa s defined at the fifth percentile of the established reference curves. For the fetal outcome parameters umbilical cord pH < 7.20, 5 min Apga r score less than or equal to 7 and operative delivery because of feta l distress, the sensitivity of FMP was 33%, 12% and 28%, the specifici ty 97%, 97%, 98%, the positive predictive value 50%, 66%, 98%, and the negative predictive value 94%, 72% and 72%, respectively. Conclusion: The fetal movement profile (FMP), as available in Kineto-Cardiotocogr aphy, has a higher specificity than antepartum CTG. The reference curv es for FMP are calculated in relation to changes of fetal motor activi ty depending on gestational age and may improve the evaluation of this parameter.