Fetal movements become noticeable between 16 to 24 weeks of pregnancy, or sometimes after 20 weeks in first pregnancies. These movements then become progressively stronger as the baby grows.
However, in pregnancies at risk of fetal and neonatal alloimmune thrombocytopenia (FNAIT), a reduction in fetal movements during pregnancy can be a sign that the baby is unwell. Certain tests can determine why fetal movements have decreased, and treatment may be required to prevent severe FNAIT complications.
Monitoring fetal movements during pregnancy
Feeling your baby move during pregnancy is both exciting and reassuring, as gentle fluttery or swirling movements gradually become stronger and may feel like kicks or rolling movements as the baby grows. While there is no rule on how often movements should be noticeable, it is important to monitor the nature and pattern of your baby’s movements in case they change.
You may feel movements more in the evening or when you’re lying down, with quieter moments when your baby is resting or sleeping. However, if you observe significantly less fetal activity, no movement or weaker movements, you must immediately inform your healthcare team. Don’t feel that you are overreacting or wasting the hospital’s time. Trust your instinct.
Learn more about FNAIT signs and symptoms
Why can fetal movements decrease in pregnancies at risk of FNAIT?
If your pregnancy is at risk of FNAIT as a result of previous FNAIT-affected pregnancies or family history, your baby will be closely monitored to detect the possible onset of FNAIT. However, the mother’s perception of fetal movements is essential in identifying a possible problem that can then be verified by checking the baby’s heartbeat and performing imaging by ultrasound to check for bleeding or hemorrhage.
Fetal movements decrease when the baby’s well-being is affected, also referred to as fetal distress or stress. While it is not the only sign that something may be wrong, it can be an important indicator of a fetus’ health when the pregnancy is at risk of FNAIT.
Reduced fetal movements may indicate the onset of FNAIT in your baby, which could cause potential long-term complications if left untreated. If you have any concerns about your baby’s movements, you must share them with your doctor.
The onset of FNAIT means the maternal antibodies progressively destroy fetal platelets, which can lead to uncontrolled internal bleeding, as blood no longer clots effectively. In the case of bleeding or hemorrhage, the baby will become weak and less active. If this occurs, urgent treatment is required to control bleeding in the gastrointestinal tract or lungs and to prevent the onset of intracranial hemorrhage.
In some FNAIT-affected pregnancies, fetal movements may also decrease if the baby’s red blood cells are affected, causing a lack of oxygen due to anemia.
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