Reduced fetal movements — MCCQE Part 1 MCQ

Correct answer: C — Arrange same-day fetal assessment with non-stress testing/ultrasound as indicated

Arrange same-day fetal assessment with non-stress testing/ultrasound as indicated is best because reduced fetal movements at term require prompt fetal assessment. Discharge without pregnancy-specific safety-netting is suboptimal because pregnancy-related bleeding, pain or hypertension can deteriorate quickly; Perform a digital vaginal examination before excluding placenta previa or instability is suboptimal because digital examination can precipitate haemorrhage when placenta previa is possible; Use a medication contraindicated in pregnancy as first-line therapy is suboptimal because maternal treatment must account for fetal safety and gestational age; Delay obstetric or gynaecologic consultation despite red flags is suboptimal because specialist involvement is needed when maternal or fetal risk is present. Reassurance by phone alone is insufficient with persistent reduced movement.

Reference: SOGC fetal health surveillance guidance