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Smith, Valerie
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Smith, Valerie
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Smith, Valerie
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Now showing 1 - 3 of 3
- PublicationReduced Fetal Movements during Pregnancy: an audit of pregnancy characteristics(2022-01-21)
; ; ; ; Maternal perception of RFM in pregnancy is a common reason for self-referral to maternity services. Preventing and reducing adverse outcomes can only be achieved through better detection and management of women with RFM, however the pregnancy characteristics of women who present with RFM in pregnancy vary.11 - PublicationA prospective case-control study of risk factors associated with reduced fetal movements during pregnancy(2022-03-10)
; ; ; ; Background: Studies have shown that women who present with reduced fetal movements (RFM) during pregnancy are at higher risk of adverse pregnancy outcomes. Preventing and reducing adverse outcomes can only be achieved through better detection and management of women with RFM. Pregnancy characteristics of women with RFM vary across studies. Aim: To examine potential risk factors for RFM in pregnancy and to determine any differences in identified risk factors between women who experience RFM and women who do not experience RFM. Methods: Ethical approval was granted by the University and Hospital Research Ethics Committees. A prospective case-control study of all women with a singleton pregnancy, presenting to the emergency department, of a large urban maternity hospital, with a primary complaint of RFM after 24 weeks’ gestation (cases) between 1 January -30 September 2020 were compared with women who did not have RFM during pregnancy (controls). Differences were described as frequencies and percentages and assessed using the Pearson Chi square test as appropriate. A p value < 0.05 was regarded as statistically significant. Logistic regression was used to assess the association of maternal characteristics for developing RFM. Findings: 850 women who presented with RFM were compared with 1743 women who did not present with RFM during the study period. Four risk factors were found to be predictive of RFM in pregnancy: age, BMI, parity and anterior placenta. Women with RFM, were significantly younger (33.8 years versus 34.4 years; p<0.01), more likely to be nulliparous (68% versus 43.8%; p<0.001; OR 2.73 95% CI 2.30-3.24), have a higher mean body mass index (26.57 kg/m2 [5.76] versus 25.89 kg/ m2 [5.10]; p<0.01) and more likely to have an anterior positioned placenta (55.6% versus 50.3%; p=0.01). Ethnicity, smoking, previous obstetric, medical history or complications during pregnancy were not found to be predictive of RFM. Conclusions: Knowledge of maternal characteristics associated with RFM could assist in identifying pregnancies at higher risk of adverse perinatal outcomes and aid decision making regarding need for further investigation when a woman presents with RFM during pregnancy.20 - PublicationThe impact of COVID-19 on attendance for reduced fetal movements during pregnancy(2022-03-10)
; ; ; ; Background: The World Health Organisation (WHO) declared a global pandemic on the 11th of March 2020. The Irish government subsequently imposed the first national lockdown and stringent measures to curb the spread of COVID-19 between March-May 2020. Concerns were raised about whether women were fearful of accessing maternity services during the lockdown. Maternal perception of reduced fetal movements (RFM) in pregnancy is a common reason for self-referral to maternity services. International guidelines recommend that women perceiving RFM attend their maternity unit for fetal assessment. Objectives: We sought to determine the impact of the first global pandemic lock-down on attendances for reduced fetal movements (RFM) during pregnancy in a large urban maternity unit. Methods: All women with a singleton pregnancy, presenting to the emergency department (ED) of the National Maternity Hospital, Dublin with a primary presentation of perceived reduced fetal movements after 24 weeks’ gestation between 1st January 2020 and 30th April 2020 were included. Findings: Between January 1 and February 29, 2020 there were 2135 total attendances to the ED; 264 of these were for RFM (12.4%). From March 1- April 30, we observed a significant decline in the number of attendances to ED, totalling 1458; 231 of these were for RFM (15.8%). During the first lock-down period (March-April 2020) overall attendances to the ED decreased by 31.7%, however referrals for RFM increased by 27.4%. Conclusions: There was a significant decrease in the number of attendances to the ED during the first lockdown of the COVID-19 pandemic, however referrals for RFM increased.89