### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I am 31 weeks pregnant with my second baby. The last few days I have noticed an increase in fetal movements lasting sometimes 45- 60 mins and only short resting times inbetween. The movements are very strong and sometimes hurt. I am under consultant care due to problems with my last pregnancy, placental abruption (minor), increased liquor volume, breech and post partum heamorrhage due to atonic uterus following c-section. So far this pregnancy has been uneventful and the baby is growing normally. Thank you.

### output:

Hallow Dear, You are 31 weeks pregnant. At this stage of pregnancy, the fetus does move freely in the uterus. When you feel it is moving rather too much, I would advise you to count the fetal movements. Count the number of times fetus moves in continuous 12 hours. A healthy fetus moves about 10 times during 12 hours period; or you can say on an average it moves once every hour. Of course, the fetus also has its own body clock. It does sleep at its own time, which may not be congruent with mothers sleep. Therefore, I advise having a foetal movement count for 12 hours. Please make note of each movement on a paper to avoid mistakes in the count. If the count is less than 10 in 12 hours, you have to report to your Obstetrician. I do empathize your concern due to previous placental abruption. However, placental abruption is a sudden event, though the cause may be over a period. So the fetus stops moving when placenta is separated. Increased fetal movements may not be indicating placental abruption. Still for your mental peace, better get ultrasonography done to ascertain the health and growth of the fetus and also integrity and maturity of placenta. If baby and placenta are healthy and normal, you need not worry about the fetal movements if they are within normal limits. Another investigation you may undergo is electronic fetal monitoring which not only will count the fetal movements but will assess the fetal cardiac activity during movements and during Braxton Hicks uterine contractions. If there is any impending risk, it will be reflected in the fetal heart tracings. I hope this guidance is useful to you.