Ž . International Journal of Gynecology & Obstetrics 74 2001 293295 Brief communication Counting fetal movements as a universal test for fetal wellbeing R. Berbey, A. Manduley, P. Vigil-De Gracia  Department of Gynecology and Obstetrics, Complejo Hospitalario Metropolitano de la Caja de Seguro Social, Panama, Panama Received 7 May 2001; received in revised form 29 May 2001; accepted 31 May 2001 Keywords: Complicated pregnancies; Fetal movements; Intrapartum fetal distress; Fetal wellbeing  Since 1973 when Sadovsky 1 described seven cases with decreased fetal movements that pre- ceded fetal death, many reports have associated decreased fetal movements with non-satisfactory fetal outcome. Fetal activity is used as an indirect way of evaluating the integrity and functionality of the central nervous system, however, a de- crease in fetal movements requires other tests before considering interruption. When fetal Ž . movements decrease, the non-stress test NST is initially indicated. In low risk pregnancies with decreased fetal movements and a reactive NST  fetal acidemia may be ruled out 2 , and a favor-  able outcome in 93% of cases is predicted 3 . The objective of our study is to determine if the decrease in fetal movements felt by the mother is sufficient to indicate a significant risk, in order to perform tests for fetal abnormalities.  Corresponding author. Apartado Postal: 87 32 24, Zona 7, Panama, Panama, Tel.: 507-230-3821; fax: 507-230-3821. ´ ´ Ž . E-mail address: pvigil-d@cwp.net.pa P. Vigil-De Gracia . A prospective study included all pregnant mothers at  35 weeks and a single gestation who attended at our institution from May 1, through August 31, 2000. All patients filled out a form during admission and in the immediate post-partum period. In this form we evaluated whether or not decreased fetal movements were noticed 1-week prior to the partum. The preg- nancy pathologies, the results of the fetal wellbe- ing test, Apgar score or fetal distress intrapartum were also included. A total of 752 pregnancies with  35 weeks of gestation were evaluated; 38.3% were nulliparous and 61.7% parous. There were 550 normal preg- nancies and 202 had medical or obstetric compli- cations. The complicated pregnancies had a higher inci- dence of decreased fetal movements than normal pregnancies, P  0.0001. Abnormal fetal tests re- Ž . sults increased P  0.0001 in normal and com- plicated pregnancies when there were decreased fetal movements. Decreased fetal movements re- 0020-729201$20.00  2001 International Federation of Gynecology and Obstetrics. All rights reserved. Ž . PII: S 0 0 2 0 - 7 2 9 2 01 00438-6