Auscultation of the fetal heart presents advantages over electronic monitoring.
Currently available data support the conclusion that within specified intervals, intermittent auscultation of fetal heart sounds is equivalent to continuous electronic fetal monitoring (EFM) for detecting intrapartum fetal compromise. One of the disadvantages of EFM is its associated increase in cesarean delivery rates. Patients should receive information on both intermittent auscultation and EFM to enable them to make an informed choice of method for intrapartum fetal assessment. Presently, EFM is routinely used with the majority of laboring patients in the United States. This is likely due to confusion regarding the proper technique used for intermittent auscultation as well as insufficient information about appropriate interventions in the event fetal bradycardia occurs. We have developed a protocol for the performance of intermittent auscultation, including recommended responses to different levels of bradycardia. Intermittent auscultation is simple, provides objective information, and appeals to many well-informed patients. In addition, when the collection of information not relevant to management decisions is eliminated, intermittent auscultation nursing requirements are not greater than with EFM. Laboring patients should receive information on both intermittent auscultation and EFM to enable them to make an informed choice of method for intrapartum fetal assessment.
Sandmire
H F
HF
Associates of Green Bay, Ltd., WI 54301, USA.
DeMott
R K
RK
D001919:Bradycardia / Q000175:diagnosis; D002585:Cesarean Section; D003657:Decision Making; D004582:Electronics, Medical; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis; D005318:Fetal Heart / Q000502:physiology*; D005323:Fetal Monitoring / Q000379:methods / Q000451:nursing; D006326:Heart Auscultation / Q000451:nursing; D006340:Heart Rate, Fetal; D006347:Heart Sounds; D006801:Humans; D007743:Labor, Obstetric; D010353:Patient Education as Topic; D011247:Pregnancy; D014481:United States