Intermittent auscultation (surveillance) of fetal heart rate in labour:
A progressive evidence-backed approach with aim to improve methodology,
convenience, reliability and patient safety.
- Shashikant Sholapurkar
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Abstract
Continued instances of serious birth asphyxia following intermittent
auscultation (IA) need not wholly imply inherent limitations. This
review uses analytical modelling to establish a safer and improved
regime. It demonstrates that the Doppler-device is superior to Pinard
stethoscope, with observation of the numerical read-out of fetal heart
rate (FHR) from the later part of contraction till the onset of next
contraction. Current recommendation of actually counting heart tones for
1 minute has many fallacies. IA should focus on the baseline FHR and
late decelerations. Detection of additional FHR changes like
accelerations, overshoots or cycling is cumbersome and adds little
value.