Purpose: to evaluate the accuracy of maternal perception of fetal movements (MPFM) in diabetic pregnant women, using Apgar score at the 1st and 5th min of life, intrapartum fetal distress and neonatal hypoxia as parameters. Methods: two hundred and nine diabetic women evaluated at the High Risk Prenatal Care Clinic of the Women's Hospital (CAISM) were analyzed retrospectively between June 1988 and May 1996. All patients had MPFM records within three days before delivery, fetal heart rate recordings during labor, gestational age greater than 30 weeks and a complete neonatal evaluation. MPFM was classified as normal if seven movements were recorded in 60 min. Results: the sensitivity of the test was 23 and 29% for Apgar score <7 at the 5th min and intrapartum fetal distress, respectively, and close to 50% for neonatal hypoxia (45.5%). Specificity was near 95% for the three standards, and the negative predictive value (NPV) was 80% for fetal distress, increasing to 97 and 98% for Apgar >7 at 5 min and neonatal hypoxia. Conclusions: MPFM is a useful test to identify diabetic women needing fetal evaluation with more complex techniques, given the high NPV, that indicates the capacity to separate the cases where the fetus is in good condition.
Diabetes in pregnancy; Fetal distress; Perinatal mortality; Diabetes mellitus
