Decreased Fetal Movement

This station was designed to test the student’s ability to perform a routine prenatal exam, and to properly react to the mother’s perception of decreased fetal movement.

The Students are Told:

Claire Clough is here at 32 weeks gestational age for a routine OB visit. Her chart indicates this has been an uneventful 1st pregnancy. Go in and evaluate Mrs. Clough.

The faculty member will serve both as in the role of Mrs. Clough’s voice (ask any questions you like), and will ask you a few questions.

Faculty:

The student will not know in advance that fetal movements are decreased.

If asked about FMs, you should respond: “I haven’t really felt any movement at all since yesterday morning.” The responses to any other questions should be normative (I’m trying to isolate this interaction to a single abnormality…decreased FM.)

Because this is both a testing and learning experience for the student, should the student not ask about FM, it is OK and desirable to prompt the student…just don’t give them any credit for asking about it.

As soon as they order an NST, give them the tracing, which is non-reactive (140, minimal variability, no accelerations, no decelerations, no contractions).

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Notes from a Medical Educator