***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Presentation d'un modele de carte pour l'enregistrement par les femmes enceintes des mouvements du fœtus qu'elles ressentent . Cette method e simple est comprehensible pour des femmes de pays et de races Background Fetal movement counting is a method used by the mother to quantify her baby 's movements , and may prevent adverse pregnancy outcome by a timely evaluation of fetal health when the woman reports decreased fetal movements . We aim ed to assess effects of fetal movement counting on identification of fetal pathology and pregnancy outcome . Methodology In a multicentre , r and omized , controlled trial , 1076 pregnant women with singleton pregnancies from an unselected population were assigned to either perform fetal movement counting from gestational week 28 , or to receive st and ard antenatal care not including fetal movement counting ( controls ) .  Women were recruited from nine Norwegian hospitals during September 2007 through November 2009 . Main outcome was a compound measure of fetal pathology and adverse pregnancy outcomes . Analysis was performed by intention-to-treat . Principal Findings The frequency of the main outcome was equal in the groups ; 63 of 433 ( 11.6 % ) in the intervention group , versus 53 of 532 ( 10.7 % ) in the control group [ RR : 1.1 95 % CI 0.7–1.5 ) ] . The growth-restricted fetuses were more often identified prior to birth in the intervention group than in the control group ; 20 of 23 fetuses ( 87.0 % ) versus 12 of 20 fetuses ( 60.0 % ) , respectively , [ RR : 1.5 ( 95 % CI 1.0–2.1 ) ] . In the intervention group two babies ( 0.4 % ) had Apgar scores < 4 at 1 minute , versus 12 ( 2.3 % ) in the control group [ RR : 0.2 ( 95 % CI 0.04–0.7 ) ] . The frequency of consultations for decreased fetal movement was 71 ( 13.1 % ) and 57 ( 10.7 % ) in the intervention and control groups , respectively [ RR : 1.2 ( 95 % CI 0.9–1.7 ) ] . The frequency of interventions was similar in the groups . Conclusions Maternal ability to detect clinical ly important changes in fetal activity seemed to be improved by fetal movement counting ; there was an increased identification of fetal growth restriction and improved perinatal outcome , without inducing more consultations or obstetric interventions . Trial Registration Clinical Trials.gov Abstract Fetal movement charting has been shown to be a reliable indicator of fetal well-being . These charts are currently being used in high-risk pregnancies , but are infrequently used in low-risk pregnancies because of concern over possible increased maternal anxiety . This study examined the effect of daily fetal movement charting on maternal anxiety in a low-risk pregnant population . Thirty-three women were r and omly assigned to an experimental ( n = 16 ) or control group ( n = 17 ) . The experimental group kept a Cardiff Fetal Movement Chart . All 33 women completed the State-Trait Anxiety Inventory at each clinic visit . The first , second , and last test scores were compared between groups using the t -test . No significant difference was found . Within each group the paired t -test was used to compare scores of the first and second , and first and last test . No significant difference was found By identifying a change in fetal activity state , fetal movement counting may help to reduce the possibility of stillbirth . Concern has arisen that such a focus on fetal activity may cause undue maternal anxiety . A prospect i ve , controlled trial was conducted to determine whether fetal movement counting induced anxiety or other deleterious psychological effects in low-risk primigravidas . A sample of 613 healthy pregnant women was r and omly assigned at 28 weeks ' gestation to fetal movement counting , sleep recording , or a nonrecording control group .  State and trait of anxiety , belief in sources of personal control , and attitudes toward pregnancy and infant were assessed at 28 and 37 weeks ' gestation . Participation rates were high ( 91.4 % ) across all groups . Most women ( 90 % ) assigned to count fetal movements did so on a daily basis ( 95 % of days ) . No significant changes in psychological status occurred in the three groups as a result of self-monitoring conditions . Independent of group assignment , all women showed a slight increase in transient state and decrease in trait of anxiety from 28 to 37 weeks . Internal locus of control and positive attitudes toward the infant increased slightly , and feelings of well-being decreased slightly for all women . It was concluded that women are willing to record fetal activity , and that fetal movement counting does not cause deleterious psychological effects in low-risk pregnant women The effect of fetal movement counting on maternal attachment to fetus was investigated in 213 women with uncomplicated singleton pregnancies at 28 to 32 weeks ' gestation . Women were r and omized into those who counted fetal movements using the Sadovsky ( n = 63 ) or Cardiff ( n = 62 ) charts and controls ( n = 88 ) . After 1 month of fetal movement counting , the Cranley 24-item scale with five subscales was used as a measure of maternal-fetal attachment . Univariate analysis revealed a statistically significant increase in total attachment scores and in each of the five attachment subscales among women who counted fetal movements ( p less than 0.0001 ) . Turkey 's studentized range test confirmed significant differences between each of the Sadovsky and Cardiff groups compared with controls ( p less than 0.05 ) . Our study suggests that fetal movement counting may enhance the maternal-fetal attachment process Objective : To compare two daily fetal movement charting techniques to determine which chart was preferred by patients and which promoted more patient adherence . Methods : This r and omized trial included patients with singleton gestations between 28 and 34 weeks ' gestation , with intact membranes and not in labor . Consenting women were given a Hollister ® chart and a ' count to 10 ' chart in a cross-over manner over two consecutive 1-week periods . Each patient answered a question naire establishing which chart was preferred . All returned charts were evaluated for patient adherence . Data were analyzed using either the Yates-corrected χ2 test or Fisher 's exact test when appropriate . Results : Forty patients agreed to participate , and 31 completed and returned both charts . The  ' count to 10 ' chart was clearly preferred over the Hollister chart ( 29 vs. 2 ; p = 0.002 ) because of the shorter recording period ( median 23 min vs. 1 h ; p < 0.01 ) . The proportion of patients who fully completed the ' count to 10 ' chart during the week was significantly higher than the proportion completing the Hollister chart ( 68 % vs. 26 % ; p < 0.001 ) . Conclusion : The  ' count to 10 ' fetal movement chart was clearly preferred and promoted a higher level of adherence An active fetus is reassuring to both the woman and her obstetrician . Numerous techniques of charting fetal movement have been shown to assist the clinician in caring for the high-risk patient . Patients ' compliance with daily monitoring is an important clinical issue , and little information exists on the fetal movement record most preferred by the patient . A comparative study evaluated patients ' acceptance of three commonly used charts . The 85 enrollees were given the different charts in a r and om manner and question ed at the next office visit . All the patients expressed approval of the concept and a lack of anxiety about such monitoring , complied with our instructions and returned the completed records . The neonatal outcomes were favorable with all the charting techniques in our antenatal fetal surveillance plan . The  " count-to-10 " method  was rated most preferred in 95.3 % of the cases . The reasons cited included convenience and less time needed to complete the recording . The mean time to complete this record was 19.7 + /- 22.9 minutes rather than one or more hours , as with the other charting methods . The results of this r and omized investigation show the simple and rapid count-to-10 method to be the most acceptable charting technique to our patients for monitoring fetal movement BACKGROUND Fetal movement counting may improve timely identification of decreased fetal activity and thereby contribute to prevent adverse pregnancy outcomes , but it may also contribute to maternal concern . This study aim ed to test whether fetal movement counting increased maternal concern . METHODS In a multicenter , controlled trial 1,013 women with a singleton pregnancy were r and omly assigned either to perform daily fetal movement counting from pregnancy week 28 or to follow st and ard Norwegian antenatal care where fetal movement counting is not encouraged . The primary outcome was maternal concern , measured by the Cambridge Worry Scale . Analysis was by intention-to-treat . RESULTS The means and SDs on Cambridge Worry Scale scores were 0.77 ( 0.55 ) and 0.90 ( 0.62 ) for the intervention and the control groups , respectively , a mean difference between the groups of 0.14 ( 95 % CI : 0.06 - 0.21 , p<0.001 ) . Decreased fetal activity was of concern to 433 women once or more during pregnancy , 45 and 42 percent in the intervention and control groups , respectively ( relative risk=1.1 , 95 % CI : 0.9 - 1.2 ) . Seventy-nine percent of the women responded favorably to the use of counting charts . CONCLUSIONS Women who performed fetal movement counting in the third trimester reported less concern than those in the control group . The frequency of maternal report of concern about decreased fetal activity was similar between the groups . Most women considered the use of a counting chart to be positive OBJECTIVE to determine midwives ' and obstetricians ' practice s for detecting and managing decreased fetal movements ( DFM )  during pregnancy . DESIGN AND PARTICIPANTS a descriptive survey of all consultant obstetricians practising obstetrics in the Republic of Irel and and a representative sample of midwives practising midwifery in all 19 maternity units in the Republic of Irel and at the time of survey distribution . METHODS following ethical approval , a question naire was mailed to consultant obstetricians and to Directors of Midwifery in September 2011 with a request for completion . Two postal reminders with further copies of the question naire were issued to non-responders . Data were analysed with SPSS Version 18 . FINDINGS midwifery and obstetric response rates to the survey were 82 % ( n=47 ) and 71 % ( n=89 ) respectively . The majority of respondents reported an absence of local guidelines for detecting and managing DFM in pregnancy . Less than 10 movements in 12 hours was the most frequently provided definition of DFM . A minority of respondents routinely recommended formal  fetal movement counting  for low-risk women ( 24 % and 19 % for midwives and obstetricians respectively ) . This increased considerably , however , for women who presented with DFM ( 62 % and 47 % in low risk women and 78 % and 51 % in high-risk women for midwives and obstetricians respectively ) . The Cardiff count-to-ten method was the chart of choice for more than 70 % of all respondents . Large variations in management strategies for women presenting with DFM was identified ; however , almost all respondents would perform a  cardiotocograph ( CTG )  in women presenting with DFM . CONCLUSION further research on DFM and , in particular , large prospect i ve studies on optimum management strategies for women presenting with DFM during pregnancy are needed We sought to determine the degree of compliance with a novel fetal movement chart ( FMC ) by high-risk patients versus the st and ard so-called count-to-10 method . This prospect i ve trial included 1400 high-risk patients . Women with singleton gestations were r and omly assigned to use either the count-to-10 chart or a FMC proposed by the Latin American Center for Perinatology ( CLAP ) . Advantages and disadvantages were identified by patients . Compliance with regimens was measured and compared between the two groups . Demographic characteristics were similar . Compliance in the CLAP group ( 448 of 700 ) was lower than in the count-to-10 group ( 638 of 700 ; 64 versus 91 % ; P < 0.0001 ) . The main advantage of the count-to-10 chart was lack of interference with daily activities . No intrauterine demises occurred in either group . High-risk patients were more compliant with the st and ard count-to-10 charting method than with the novel FMC . The count-to-10 method is an easy and inexpensive tool for fetal monitoring and should continue to be used in obstetric practice Maternal assessment of fetal movement and human placental lactogen ( HPL ) estimation were compared as predictors of fetal outcome in a prospect i ve study of 135 antenatal patients . The sensitivity , predictive value and specificity for each test are presented . Abnormal fetal movements gave a better predictive index than abnormal HPL levels . The risk of poor fetal outcome is greatest when both parameters are abnormal The routine recommendation to women to count fetal movements daily during late pregnancy for the prevention of antepartum late fetal death in normally formed singletons has been evaluated . 68,000 women were r and omly allocated within thirty-three pairs of clusters either to a policy of routine counting or to st and ard care , which might involve selective use of formal counting or informal noting of movements .  Antepartum death rates for normally formed singletons were similar in the two groups , regardless of cause of prior risk status . Despite the counting policy , most of these fetuses were dead by the time the mothers received medical attention . The study does not rule out a beneficial effect , but at best , the policy would have to be used by about 1250 women to prevent 1 unexplained  antepartum late fetal death , and 
    Output:
    
Indirect evidence from a large cluster- RCT suggested that more babies at risk of death were identified in the routine fetal monitoring group , but this did not translate to reduced perinatal mortality .