Cross-over trial comparing maternal acceptance of two fetal movement charts

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 randomized 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 questionnaire 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.