Hypothesis: Reduced fetal movements is a symptom of placental insufficiency. This insufficiency can be detected antenatally using placental ultrasound, fetomaternal Doppler ultrasound and quantification of fetoplacentally-derived factors in the maternal circulation. Detecting placental insufficiency antenatally can predict placentally-derived adverse pregnancy outcome Methods: a cohort study of 300 singleton, non-anomalous pregnancies where mothers reported at least one episode of reduced fetal movements after at least 28 weeks gestation. Details of the methods of the study can be found in the related publications (PMID 27238714, INSERT PMID'S HERE) . Results: 300 participants were recruited. 2 were lost to follow up. 2 received postnatal diagnoses of significant fetal abnormalities and were excluded. 61/296 (20.6%) experienced adverse pregnancy outcome. Combining measures of placental function (PlGF/sFlt1 ratio and umbilical artery Doppler impedance) with estimation of fetal weight demonstrated improved test performance characteristics. Details of the results can be found in the related publication (INSERT PMID HERE). Conclusion: This study identified two clinical measures relating to placental health that have the potential to incrementally improve prediction of adverse pregnancy outcome after reduced fetal movements. However, these tests require further development and evaluation of their link to placental dysfunction and fetal wellbeing. The full diagnostic potential of these tests, particularly of the PlGF/sFlt1 ratio, needs to be prospectively assessed in future studies.
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Details of the methodologies can be accessed in the related publications (see below)