الفهرس 
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Abstract
Summary
Maternal counting of fetal movements is an easy, inexpensive and valuable screening tool for fetal well-being that increases maternal-fetal bonding. Prenatal attachment has been defined as ”The emotional tie or bond which normally develops between the pregnant women and her unborn child”(Marzouk and Nabil, 2015).
Fetal movements provide an important measure of fetal health. More than half of stillbirths are preceded by decreased fetal movements and 25% of mother perceiving decreased fetal movements have poor perinatal outcomes according to most of studies (Bryant, et al., 2019).
One function of these movements is to alert the pregnant mother that she has a fetus growing in size and strength in her uterus. Decreased fetal movements can be a warning sign of potential fetal impairment or risk. Most providers recommend that pregnant mother monitor fetal movements, especially by the third trimester. This can be accomplished by simply teaching the mother to have a general awareness of the fetus and determine if the fetus is moving less than normal on any given day or about the same as other days using fetal movements count (FMC) (Das., et al., 2019).
Maternal perceptions of fetal movements are the result of pressure against abdominal wall due to gross fetal movements or limb movement. Monitoring fetal movements is a useful tool to assess fetal well-being (Nandi, and Agarwal, 2019).
The maternity nurses play a crucial role in fetal monitoring and early detection of high risk fetus (Lewis, et al., 2016). The importance of monitoring of fetal movements should be discussed at each antenatal appointment from 20 weeks gestation, so mother should be advised to be aware of their fetus’s individual pattern of movements. Mother who is concerned about RFM should not wait until the next day for assessment of fetal wellbeing. It is also important to record the advice given about follow-up and when/where to present if a further episode of RFM is perceived (Moon, 2017).
The normal fetus is active and capable of physical movements, and goes through periods of both rest and sleep. Active and quite periods of the fetus do not correspond to that mother. Some research reveals those fetuses are most active from 9am to 2pm and again from 7pm to 4am (Kintraia, et al., 2017).
This study aimed to increasing awareness of primigravidas about fetal movements during pregnancy and this achieved through; assessing perception and knowledge of primigravidas regarding fetal movements and health education to increase awareness of primigravidas regarding fetal movements.
The study was carried out using a Cross-sectional research design was at El-Dakhla in New Valley governorate from outpatient clinics of two- setting ( El –Dakhla general hospital & Family Health Center in El –Dakhla) , El –Dakhla general hospital. A Convenient sample was used for all primigravidas and the period of data collection was one year from (August 2018 to September 2019), they were (100) participants’ mothers.
Methods of data collection were done through the use of Structured interviewing questionnaire: designed, validated and utilized by the researcher and supervisors which included the following parts: The first part, involved personal data as (mother’s age, residence, level of education and occupation and mother’s telephone number), current obstetric data and attending antenatal visits as (duration of marriage, date of LMP, gestational age, EDD, schedule of antenatal care follow up ….etc), The second part, assess maternal perception about fetal movements this part encompassed of 8 questions with scoring system negative or positive attitude and two general questions and the third part, assess maternal knowledge about fetal movements .It comprised of 20 questions with scoring system satisfactory or unsatisfactory knowledge.
To carry out the study an official permission was obtained from the director of El –Dakhla general hospital and the director of Family Health Center at El – Dakhla at New Valley governorate; proposal was approved from ethical committee of the Faculty of Nursing. Oral informed consent was obtained from mothers who were participated in the study; it included full explanation of nature of the study, the procedure, and rights for privacy and confidentiality.
The researcher interviewed all primigravidas from 20 weeks of gestation attending at F.H.C and El –Dakhla general hospital. The researcher greets the mother, introduces self and explains the benefit and purpose of the study and the confidentiality & anonymity of participants were assured by the researcher. Mothers were informed that completion of the research is completely voluntary and oral consent was taken.
Firstly the researcher greets mother and each mother was interviewed separately to fulfill the tool and assess the mother’s knowledge & perception. Researcher met mothers two days by weeks (Monday and Wednesday) at Family Health Center and one day (Saturday) in outpatient clinic at El- Dakhla general hospital because the follow up of pregnancy and vaccination of pregnant mother taken in this days started from 9 Am to 12 Pm, the data collection took about 30 minutes for each mother.
The mother counseled about scientific knowledge regarding fetal movements counting and guided by Arabic brochure was designed based on National and International review and included pictures for illiterate mother. This brochure instruct the mother about the importance and factors affecting fetal movements, how to count fetal movements and what are the right action taken if reducing or unusual F.M was happen. Ask the mother to use a notebook or a chart to record the time taken for fetus move to make it easily accessible and this idea used and accepted by most of mothers when I saw them in other follow up visits.
The study results revealed the following:
• The majority of studied mothers (96%) shows positive perception regarding fetal movements
• Approximately two third of the studied mothers (70%) have unsatisfactory knowledge regarding fetal movements count.
• Most of studied mothers (88%) made the wrong action in case of unusual fetal movements and no one of them know any method of fetal movements counting.
• There was no statistically significant difference between perception level of studied mothers regarding fetal movements and their knowledge level.
• There was a significant relationship between level of knowledge regarding fetal movements and mothers’ age, level of education and residence with P-Value (0.004*, 0.001*&0.009* respectively)
In conclusion, Results of the present study concluded that the most of the studied mothers have active perception but unsatisfactory knowledge regarding fetal movements and most of them made the wrong action in case of unusual fetal movements and no one of them know any method of fetal movements counting. There was a significant relationship between level of knowledge regarding fetal movements and women’s age, level of education and residence.
Therefore, it is recommended that, fetal movements counting should be a basic part of guidelines of antenatal care in all hospitals & all Maternity health centers for continuous education.
Increase attention to primigravidas by health care provider through refreshing courses and in-service training.
Further studies are needed in this field on large numbers of primigravidas in New Valley to increase knowledge and practices regarding fetal movement