Pearson Fetal Movement Test "Count to Ten"

Starting from the 28th week of pregnancy, on a special map, mark the number of perceptible movements of the baby every day. Start counting at 9 am and end at 9 pm. During these 12 hours, the baby must push you at least 10 times. It is this number of movements per day that is considered normal. In the map, you enter the time of the 10th perturbation. A small number of shocks - less than 10 per day - may indicate fetal oxygen deficiency and is a reason to see a doctor.

Fetal movement - how and when it happens

1. At what time does fetal movement begin
2. Fetal movement rate
3. Methods for assessing the "sufficiency" of fetal movements
4. Changes in fetal activity
5. Determining the condition of the fetus

“Dear patients, we are glad to welcome you to the website of the Fetal Medicine Center – a medical center of expert level in the field of modern prenatal medicine.

We see our mission in making the expectation of a child and its birth a happy, calm and most comfortable period for every woman. By providing professional medical support, we help couples plan pregnancy, control its harmonious course, conduct expert-level prenatal diagnostics, providing comprehensive care for the health of the expectant mother and baby. ”

Roza Saidovna Bataeva

Head of the Fetal Medicine Center in Moscow

From the very beginning of pregnancy, every expectant mother begins to listen anxiously to the sensations inside her growing belly. Can't wait to feel your baby move. When does the fetus begin to move? At what time can a pregnant woman begin to listen carefully to herself, waiting for the first movements of her child? Should I be worried if they are not felt or the baby suddenly calmed down? And can movements carry any other information, besides communicating with mom?

At what time does the fetal movement begin

The first movements of the future baby begin early - as early as 7-8 weeks of pregnancy . It was at this time that the first muscles and the rudiments of the nervous system of the fetus are formed. Naturally, at this time, the movements of the embryo are still very primitive - these are muscle contractions in response to nerve impulses.

Approximately from 10 weeks of pregnancy the fetus begins to move more actively in the uterus, and, encountering an obstacle on its way (walls of the uterus), change the trajectory of movements. However, the baby is still very small and the impacts on the uterine wall are very weak, the expectant mother cannot yet feel them. At 11-12 weeks of intrauterine life, a little man already knows how to clench his fists, grimace, frown, by 16 weeks of pregnancy he begins to react to loud, sharp sounds with increased motor activity, at 17 weeks the first facial expressions appear, and at 18 weeks he covers his face with his hands and plays with the umbilical cord, clenching and unclenching the fingers.

Gradually, with increasing gestational age, movements become more coordinated and more like conscious. When the baby grows up, the pregnant woman begins to feel his movements.

When does the fetal movement begin during the first and subsequent pregnancies

It is generally accepted that during the first pregnancy, the expectant mother feels the first fetal movements at 20 weeks of pregnancy, with repeated pregnancies - at 18 weeks. This is not entirely true. A mother who is expecting her first child, indeed, most often begins to feel the movements of the fetus a little later than a multiparous woman. This is due to the fact that "experienced" mothers know how the movements of the crumbs are felt at first and what they should feel. Some primigravidas perceive the first movements of the fetus as an increase in intestinal peristalsis, “gaziki”. Many women describe the first movements of the fetus as a feeling of fluid transfusion in the abdomen, "fluttering butterflies" or "swimming fish."

The first movements are usually rare and irregular. The time of the first sensations of fetal movements naturally depends on the individual sensitivity of the woman. Some future mothers feel the first movements as early as 15-16 weeks, and someone only after 20. Slender women, as a rule, begin to feel movements earlier than full ones. Women who lead an active lifestyle, work hard, usually feel the movements of the fetus later.

By 20 weeks, due to the formation of the spinal cord and brain, as well as the accumulation of a certain amount of muscle mass in the fetus, movements become more regular and noticeable .

From 24 weeks of pregnancy, the movements of the fetus are already reminiscent of the movements of a newborn - the expectant mother feels how the fetus changes position, moves its arms and legs. The motor activity of the fetus increases gradually and its peak falls on the period from the 24th to the 32nd week of pregnancy. At this time, the activity of the baby's movements becomes one of the indicators of its normal development. After 24 weeks, the child begins to "communicate" with the mother with the help of movements, respond to the sounds of voice, music, and the emotional state of the mother. With an increase in the gestational age of more than 32 weeks, the motor activity of the fetus gradually decreases due to the fact that the baby is growing up and he simply does not have enough space for active movements. This becomes especially noticeable at the time of childbirth. By the end of the third trimester of pregnancy, the number of fetal movements may decrease somewhat, but their intensity and strength remain the same or increase.

Fetal movement rate

The baby in the mother's belly moves almost constantly. At the 20th week of pregnancy, the fetus makes about 200 movements per day, and between the 28th and 32nd weeks, the number of movements reaches 600 per day. Naturally, a pregnant woman does not feel all the movements of the fetus, but only a small part of them. So, after 28 weeks, the frequency of fetal movement, according to the sensations of a woman, is usually 4 to 8 times per hour, with the exception of periods of fetal sleep (3-4 hours in a row).

In the third trimester, a pregnant woman may notice that her baby has regular sleep and wake cycles. Children are usually most active from 19:00 to 4:00 in the morning, and the period of "rest" occurs more often from 4 to 9:00 in the morning. Of course, the movements of the fetus depend on the mood of the mother, if the mother is worried or happy, the baby can move more actively, or vice versa, calm down. The fact is that when a mother rejoices, her body significantly increases the amount of hormones of joy - endorphins, which regulate the work of the heart and blood vessels, including the vessels of the placenta. During stress or pronounced negative emotions, biologically active substances are also produced - stress hormones, they also affect the work of the heart and blood vessels. It is thanks to this biological interaction between the organisms of mother and baby that the fetus feels the state of the mother. When the expectant mother is resting, the baby usually becomes more active, if the pregnant woman is active, busy with some kind of work, the child most often calms down. The movements also change depending on the satiety of the expectant mother. Usually the baby begins to move actively after the mother eats, especially something sweet. At the same time, the level of glucose in the blood increases sharply, which causes the fetus to be more active.

Fetal movements are the language in which the unborn child speaks to the mother. Naturally, a pregnant woman should listen to the movements, because in some cases, changes in the movements of the fetus may indicate a violation of its intrauterine state and a not entirely successful pregnancy.

If, after 20 weeks of pregnancy, the expectant mother does not feel fetal movement, it may be worthwhile to see a doctor and make sure that everything is in order with the baby.

Methods for assessing the "sufficiency" of fetal movements

Counting the number of movements

The easiest way to assess fetal movements is to count the number of movements of the pregnant woman herself. Self-assessment methods are very easy to use, do not require additional equipment, the presence of a doctor and are easily reproducible by any woman. Their disadvantages are that each woman has different thresholds of susceptibility.

Count to ten

The most common method for assessing fetal movements is called count to ten . It can be carried out after 28 weeks of pregnancy, when the fetus is mature enough for active movements. Its essence lies in the fact that the expectant mother counts the movements of the fetus for a 12-hour time interval, for example, from 9 am to 9 pm. The time when a pregnant woman catches the tenth movement is recorded on a tablet. If the fetus makes less than 10 movements in 12 hours, this is a reason to consult a doctor for an additional examination.

Sadowski method

In the evening after dinner (approximately between 19until 11 p.m.), the woman lies on her left side and counts the movements of the fetus. At the same time, everything is considered, even the smallest movements. If 10 or more movements are noted within an hour, this indicates that the baby is moving quite actively and feels good. If the fetus moved less than 10 times in an hour, then the movements are counted for the next hour. Evening time for this assessment method was not chosen by chance. It is in the evening hours, especially after dinner and the associated increase in glucose, that the greatest activity of the fetus is noted. If the number of fetal movements during this test is less than 10 per two hours, this should be considered as a sign of a violation of his condition and additional studies should be carried out.

For an obstetrician-gynecologist, fetal movements are also an important diagnostic criterion for some deviations in the course of pregnancy from the norm. Too active, violent, painful fetal movement or weak, rare movements may indicate its unfavorable condition.

Changes in fetal activity

Changes in fetal activity may be associated with external influences. For example, if a pregnant woman lies on her back for a long time, then the enlarged uterus compresses a large vessel - the inferior vena cava, the blood flow to the fetus is disrupted, which immediately causes its violent reaction - active movements. The same changes in the activity of the baby can occur in any other uncomfortable position of the mother - if she leans forward, squeezing her stomach, sits with her legs crossed, the child forces her mother to change her position with her activity. A similar situation occurs if the baby himself squeezes or presses the loops of the umbilical cord, limiting the flow of blood through it. He begins to move more actively, changes his position and relieves pressure on the umbilical cord. However, in some cases, an increase or vice versa, a subsidence of fetal movements can be a sign of a serious pathology.

After 28 weeks of pregnancy, if your baby does not let you know for 3-4 hours, he may just be sleeping. In this case, the expectant mother needs to eat something sweet and lie down on her left side for half an hour. If these simple manipulations do not lead to a result, it is worth repeating them again after 2-3 hours. If this time the baby does not make itself felt, this is an occasion to consult a doctor. Rare and weak movements can also indicate a fetal problem, most often a lack of oxygen for the baby, that is, fetal hypoxia.

Determining the condition of the fetus

To determine the condition of the fetus, the doctor conducts a series of examinations:

Auscultation (listening)

The simplest is auscultation (listening) using a special wooden tube (obstetric stethoscope) or a special device that captures the heartbeat of the fetus, doctor listens to the baby's heartbeat. Normally, it is about 120-160 beats per minute. A decrease in heart rate less than 120 or an increase of more than 160 indicates intrauterine suffering of the child.

Ultrasound and dopplerometry

During ultrasound, the doctor visually assesses the size of the fetus, the compliance of the development of the fetus with the gestational age, because with oxygen starvation, the growth rate of the fetus slows down and its size lags behind the norm for each gestational age. Also important is the structure of the placenta, the presence of signs of aging in it, as a result of which the function of transferring blood, oxygen and nutrients to the fetus usually worsens. During ultrasound, the amount and type of amniotic fluid is assessed, which can also change with intrauterine fetal suffering. Dopplerometry of the vessels of the placenta and umbilical cord is a method for studying blood flow velocities in these vessels. With a decrease in the speed of blood flow in any vessel, one can speak of fetal malnutrition of varying severity.

Cardiotocography (CTG)

This is an important method for assessing the condition of the fetus. CTG is performed at a gestational age of 33 weeks or more, since only in this period of intrauterine development of the baby is a full-fledged regulation of the activity of the cardiovascular system of the fetus by the centers of the spinal cord and brain. Recording of fetal heartbeats is carried out for at least 40 minutes, and if necessary, the study can be extended up to one and a half hours. The device registers and records the baby's heart rate. For example, with a decrease in the concentration of oxygen in the blood of the fetus, the supply of oxygen to the cells of the nervous system decreases, which in turn affects the heart rate, especially during the period of wakefulness of the child. The obstetrician-gynecologist evaluates the heartbeat recording curve, episodes of slowing down and a sharp increase in the fetal heart rate, and based on these data, makes a conclusion about how comfortable the baby feels in the mother's stomach.

If during additional methods for assessing the condition of the fetus, initial disturbances in the supply of oxygen to the baby are detected, drug treatment is carried out aimed at increasing the access of blood and oxygen through the placenta and mandatory control examinations against the background of ongoing therapy. If the changes are profound and the baby experiences a pronounced deficiency of oxygen and nutrients, his condition suffers, an emergency delivery of such a patient is performed.

Fetal movements are not only an indicator of his condition, it is a way of communication between the baby and parents. The movements of the crumbs in the mother's tummy are unforgettable sensations that a woman can experience only in this short, but such a happy period of her life.

Center for Fetal Medicine in Moscow:

The main activities of our center are the early detection of congenital malformations in the fetus, prenatal screening for the detection of chromosomal abnormalities in the fetus, as well as pregnancy complications such as preeclampsia, fetal growth retardation and threatened abortion.

Our center is organized in such a way that the whole range of services is concentrated in one place, where a woman receives the results of various types of examinations, including ultrasound, biochemical, and specialist consultation within 1-1.5 hours. In the presence of a high risk for chromosomal diseases in the fetus, invasive diagnostics and genetics consultation are carried out here in the center.

Fetal echocardiography is given special attention in our center, since congenital heart defects in the fetus are increasingly common today, but, unfortunately, are often missed during ultrasound during pregnancy.

In view of the ever-increasing number of multiple pregnancies, which requires more time and a special approach, the observation of women with multiple pregnancies has been allocated to us in a separate clinic for multiple pregnancies.

All examinations in the center are carried out according to the international standards FMF (Fetal Medicine Foundation) and ISUOG (International Society for Ultrasound in Obstetrics and Gynecology). In complex clinical cases, we can consult with specialists from King's College Hospital, King's College Hospital (London, UK).

The team is a special pride of the center. Our doctors are not only one of the leading specialists, professors, doctors and candidates of medical sciences, doctors of the highest categories, they are also a team of like-minded people and real enthusiasts in their field.

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