The impact of COVID-19 on attendance for reduced fetal movements during pregnancy

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.