title: The Use of Intermittent Auscultation in Parturients of Varying BMI Categories: Experience From a Mid-Sized Tertiary Care Obstetrical Unit.
abstract: OBJECTIVE
  The aim of this quality assurance project was to determine how many patients who qualified for intermittent auscultation (IA) in labour were actually monitored by intermittent auscultation. A secondary objective was to assess whether the rate of IA use depended on maternal BMI.
  
  
  METHODS
  We performed a retrospective chart review in a sample of women who received obstetrical care at Kingston General Hospital over one year from July 31, 2012. Eligibility was determined using the inclusion and exclusion criteria outlined by the hospital's guideline on intermittent auscultation.
  
  
  RESULTS
  Two hundred seven of 244 charts analyzed in this review qualified for IA. The mean age of women in the study was 29.3 (range 17 to 41) years. Their mean gestational age was 39.6 (range 37 to 42) weeks. Fifty-six percent (116/207) of the eligible women actually had IA. Forty-seven percent of obese women who were eligible (47/100) had IA, compared with 64.4% of overweight women (58/90). This difference (17.4%) was statistically significant (P = 0.019, Fisher exact test).
  
  
  CONCLUSIONS
  Fifty-six percent (116/207) of women with low risk pregnancies who were deemed eligible to have IA rather than electronic fetal heart rate monitoring actually had IA. Obese women were less likely to have IA than overweight women. More research is required regarding barriers to using IA in eligible women in our institution and elsewhere.
authors.affiliation: Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
authors.forename: Sheila Sheth
authors.initials: SS
authors.lastname: Thakkar
authors.affiliation: Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lammers
authors.affiliation: Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Hahn
authors.affiliation: Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.
authors.forename: Ashley
authors.initials: A
authors.lastname: Waddington
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015148:Cardiotocography / Q000379:methods / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D063128:Tertiary Health Care / Q000706:statistics & numerical data
keywords: Caesarean section; cardiotocography; fetal heart rate; fetal monitoring; health care; obstetric labour; quality assurance