The Use of “FetalKickApp” for Counting Fetal Movement in Pregnant Women: A Case Study of The University of Port Harcourt Teaching Hospital, Nigeria
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Keywords
fetal, pregnancy, kicks, app, stillbirths, smartphone
Abstract
Background: The global stillbirth rate is 13.9 stillbirths per 1000 births, with most stillbirths being recorded in developing countries. Most cases of stillbirth are preceded by reduced fetal movement. Early detection of reduced fetal movement is a key element in reducing the number of stillbirths. Therefore, a “FetalkickApp” that is a self-monitoring digital health tool, assists a pregnant woman to count, record, and send her fetal movement count to her health care provider without the use of mobile data or internet.
Methodology: This study is a longitudinal pilot study involving 25 pregnant women with single fetuses between 28 and 38 weeks of gestation. The mobile application monitor was used to record the number of fetal movements for 4 weeks. A 5-point Likert scale questionnaire is used to assess the use of the application, interface experience, satisfaction with the design, and function of the application without internet.
Results: The mean age of the women is 31.2 (±4.5) years, and the mean gestational age is 29.5 (±2.4) weeks. The results obtained show that the majority of the women (72%) had good knowledge of fetal movement. About two-thirds (64%) of the women agreed that the FetalkickApp is helpful in counting their fetal movement. Forty-four per cent (44%) of the women strongly agreed that the application is easy to use, and 68% of the women agreed that the FetalkickApp's effectiveness is satisfactory.
Conclusion: The FetalkickApp is independent of the internet, which means that it could be used everywhere. The interface and design of the application are simple and could be operated by any individual concerned.
References
2.) Rådestad I. Fetal movements in the third trimester—Important information about wellbeing of the fetus. Sex Reprod Healthc. 2010; 1(4): 119–21. https://doi.org/10.1016/j.srhc.2010.06.006.
3.) Heazell AEP, Frøen JF. Methods of fetal movement counting and the detection of fetal compromise. J Obstet Gynaecol. 2008; 28(2): 147–54. https://doi. org/10.1080/01443610801912618.
4.) Berbey R, Manduley A, Vigil-De Gracia P. Counting fetal movements as a universal test for fetal wellbeing. Int J Gynaecol Obstet. 2001; 74(3):293–5. DOI: 10.1016/s0020-7292(01)00438-6
5.) Linde A, Pettersson K, Rådestad I. Women’s experiences of fetal movements before the confirmation of fetal death– Contractions misinterpreted as fetal movement. Birth. 2015; 42(2): 189–94. https://doi.org/10.1111/birt.12151.
6.) Gilchrist L. Assessing in-utero activity. Br J Midwifery. 2015; 23(6): 406–11. https://doi.org/10.12968/ bjom.2015.23.6.406.
7.) Mangesi L, Hofmeyr GJ, Smith V, Smyth RMD. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2015; (10): CD004909. https://doi. org/10.1002/14651858.CD004909.pub3.
8.) Saastad E, Winje BA, Israel P, Frøen JF. Fetal movement counting-maternal concern and experiences: a multicenter, randomized, controlled trial. Birth. 2012; 39(1):10–20. https://doi. org/10.1111/j.1523-536X.2011.00508.x.
9.) Einspieler C, Prayer D, Marschik PB. Fetal movements: the origin of human behaviour. Developmental Medicine & Child Neurology. 2021;63(10):1142-8. DOI: 10.1111/dmcn.14918
10.) Eshraghi N, Jamal A, Eshraghi N, Kashanian M, Sheikhansari N. Cerebroplacental ratio (CPR) and reduced fetal movement: predicting neonatal outcomes. The Journal of Maternal-Fetal & Neonatal Medicine. 2022; 35(10):1923-8. DOI: 10.1080/14767058.2020.1774544
11.) Winje BA, Wojcieszek AM, Gonzalez-Angulo LY et al. Interventions to enhance maternal awareness of decreased fetal movement: a systematic review. BJOG. 2016; 123(6): 886–98. https://doi.org/10.1111/1471-0528.13802.
12.) Thompson JM, Wilson J, Bradford BF, Li M, Cronin RS, Gordon A, Raynes-Greenow CH, Stacey T, Cullling VM, Askie LM, O’Brien LM. A better understanding of the association between maternal perception of foetal movements and late stillbirth—findings from an individual participant data meta-analysis. BMC Medicine. 2021; 19(1):267. DOI: 10.1186/s12916-021-02140-z
13.) Flenady V, Gardener G, Ellwood D, Coory M, Weller M, Warrilow KA, Middleton PF, Wojcieszek AM, Groom KM, Boyle FM, East C. My Baby’s Movements: a stepped‐wedge cluster‐randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths. BJOG: An International Journal of Obstetrics & Gynaecology. 2022; 129(1):29-41.DOI: 10.1111/1471-0528.16944
14.) Pegorie C, Liu B, Thilaganathan B, Bhide A. Antenatal noninvasive fetal electrocardiography: a literature review. Maternal-Fetal Medicine. 2024;6(03):178-89. DOI: 10.1097/FM9.0000000000000237
15.) Ding JJ, Paoletti O, Culhane J, Lundsberg L, Partridge C, Cross SN. Maternal Characteristics and Pregnancy Outcomes Associated with Delivery versus Expectant Management following Decreased Fetal Movement at Term. American Journal of Perinatology. 2025;42(10):1243-8. DOI: 10.1055/a-2486-7
16.) Hug L, You D, Blencowe H, Mishra A, Wang Z, Fix MJ, et al. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021; 398(10302):772-785. doi: 10.1016/S0140-6736(21)01112-0
17.) Xu J, Zhao C, Ding B, Gu X, Zeng W, Qiu L, Yu H, Shen Y, Liu H. Fetal movement detection by wearable accelerometer duo based on machine learning. IEEE Sensors Journal. 2022; 22(12):11526-34. DOI: https://doi.org/10.1109/JSEN.2022.3172451
18.) Kasso T, Alegbeleye JO, Jeremiah I. Determinants of Intrauterine Fetal Death among Unbooked Paturients at the University of Port Harcourt Teaching Hospital, Southern Nigeria. Arch Curr Res Int. 2020; 20(3): 34-40. https://doi.org/10.9734/acri/2020/v20i330182
19.) Draper ES, Kurinczuk JJ, Kenyon S (eds). MBRRACE-UK Perinatal Confidential Enquiry: Term, singleton, normally formed, antepartum stillbirth. Leicester: The Infant Mortality and Morbidity Studies, Department of Health Sciences, University of Leicester; 2015. https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Perinatal%20Report%202015.pdf
20.) Mesbah M, Khlif MS, Layeghy S, East CE, Dong S, Brodtmann A, Colditz PB, Boashash B. Automatic fetal movement recognition from multi-channel accelerometry data. Computer methods and programs in biomedicine. 2021; 210:106377. DOI: 10.1016/j.cmpb.2021.106377
21.) Kamphof HD, Posthuma S, Gordijn SJ, Ganzevoort W. Fetal growth restriction: mechanisms, epidemiology, and management. Maternal-Fetal Medicine. 2022;4(03):186-96. DOI: 10.1097/FM9.0000000000000161
22.) Warland J, O’Brien LM, Heazell AE, Mitchell EA; STARS Consortium. An international internet survey of the experiences of 1,714 mothers with a late stillbirth: the STARS cohort study. BMC Pregnancy Childbirth. 2015; 15(1): 172–81. https://doi.org/10.1186/s12884-015-0602-4.
23.) King VJ, Bennet L, Stone PR, Clark A, Gunn AJ, Dhillon SK. Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses. Frontiers in physiology. 2022;13:959750. doi: 10.3389/fphys.2022.959750.
24.) Bradford BF, Hayes DJ, Damhuis S, Shub A, Akselsson A, Radestad I, Heazell AE, Flenady V, Gordijn SJ. Decreased fetal movements: Report from the International Stillbirth Alliance conference workshop. International Journal of Gynecology & Obstetrics. 2024;165(2):579-85. DOI: 10.1002/ijgo.15242
25.) Pollock D, Ziaian T, Pearson E, Cooper M, Warland J. Breaking through the silence in antenatal care: Fetal movement and stillbirth education. Women Birth. 2020; 33(1):77-85. doi: 10.1016/j.wombi.2019.02.004.
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