{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T02:13:00Z","timestamp":1761271980715,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To describe how decreased fetal movement (DFM) was managed in patients with fetomaternal hemorrhage (FMH) and to evaluate the diagnostic limitations of this condition in real\u2010world settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included individuals who developed FMH with cerebral palsy from the Japanese nationwide cerebral palsy registry between 2009 and 2022. We investigated whether patients experienced DFM or were prenatally diagnosed with FMH. Furthermore, we assessed how DFM was managed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 57 patients who developed FMH with cerebral palsy, and none were prenatally diagnosed with FMH. DFM was present in 43\/57 (75.4%) patients. A sinusoidal pattern was observed in 29\/57 (50.9%) patients, and elevated middle cerebral artery peak systolic velocity (MCA\u2010PSV) was detected in 6\/10 (60.0%) patients who underwent this test. Of the 43 patients with DFM, 42 (97.7%) sought medical care for this symptom; however, only 12 (27.9%) underwent examinations on the same day as the onset of DFM, and 9 (20.9%) were admitted on that same day. Furthermore, 6\/43 (14.0%) were instructed to stay home after telephone consultation or medical examination for this symptom. In five of the 43 patients (11.6%) who experienced DFM, the initial non\u2010stress test was reactive. However, all these patients eventually developed either a non\u2010reactive or non\u2010reassuring fetal status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DFM was prevalent among pregnancies complicated by FMH; however, it was often inadequately managed, resulting in diagnostic delays. Furthermore, fetal heart rate monitoring and MCA\u2010PSV evaluations had diagnostic limitations. To facilitate early treatment, clinicians need to promptly assess preceding DFM while recognizing the limitations of existing tests.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70106","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:38:29Z","timestamp":1760171909000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges in the Management of Decreased Fetal Movement in Fetomaternal Hemorrhage With Cerebral Palsy: A Nationwide Registry Study"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-8726","authenticated-orcid":false,"given":"Yoshimitsu","family":"Wada","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1652-9438","authenticated-orcid":false,"given":"Hironori","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-1782","authenticated-orcid":false,"given":"Manabu","family":"Ogoyama","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotada","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rie","family":"Usui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8815-5714","authenticated-orcid":false,"given":"Seung Chik","family":"Jwa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8861-1572","authenticated-orcid":false,"given":"Akihide","family":"Ohkuchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000271212.66040.70"},{"key":"e_1_2_13_3_1","first-page":"323","article-title":"Massive Fetomaternal Hemorrhage: Manitoba Experience","volume":"83","author":"Almeida V.","year":"1994","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181da7929"},{"key":"e_1_2_13_5_1","first-page":"711","article-title":"Massive Fetomaternal Hemorrhage Preceded by Decreased Fetal Movement and a Nonreactive Fetal Heart Rate Pattern","volume":"82","author":"Kosasa T. 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