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Antenatal evaluation of the fetus using fetal movement monitoring.

The concept of monitoring fetal body movements has existed for more than a century. Early knowledge of fetal neurologic function was based on maternal perception of aborted fetuses and on systematic studies of newborn infants. Information on how the fetus moves and about quantitative and qualitative movement patterns during gestation has become available in the last few decades. Real-time ultrasound has allowed a quality assessment of the comprehensive motor repertoire in healthy and undisturbed fetuses in their natural environment. This information has enabled characterization of fetal movements in growth-restricted fetuses, fetuses destined to deliver prematurely, and those with either congenital malformations or chromosomal disorders. This manuscript addresses the monitoring of fetal movements, focusing on methods to record and classify different activities. Relations between fetal movement and either simultaneous fetal heart rate (FHR) accelerations or external stimuli are described, especially in relation to a cascade of fetal testing. Limitations to fetal movement monitoring and special considerations are discussed.