title: Heart Rate Assessment Immediately after Birth.
abstract: BACKGROUND
  Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best method to measure heart rate.
  
  
  OBJECTIVE
  The aim of this study was to assess different methods of heart rate assessment in newborn infants at birth to determine the fastest and most accurate method.
  
  
  METHODS
  PubMed, EMBASE and Google Scholar were systematically searched using the following terms: 'infant', 'heart rate', 'monitoring', 'delivery room', 'resuscitation', 'stethoscope', 'auscultation', 'palpation', 'pulse oximetry', 'electrocardiogram', 'Doppler ultrasound', 'photoplethysmography' and 'wearable sensors'.
  
  
  RESULTS
  Eighteen studies were identified that described various methods of heart rate assessment in newborn infants immediately after birth. Studies examining auscultation, palpation, pulse oximetry, electrocardiography and Doppler ultrasound as ways to measure heart rate were included. Heart rate measurements by pulse oximetry are superior to auscultation and palpation, but there is contradictory evidence about its accuracy depending on whether the sensor is connected to the infant or the oximeter first. Several studies indicate that electrocardiogram provides a reliable heart rate faster than pulse oximetry. Doppler ultrasound shows potential for clinical use, however future evidence is needed to support this conclusion.
  
  
  CONCLUSIONS
  Heart rate assessment is important and there are many measurement methods. The accuracy of routinely applied methods varies, with palpation and auscultation being the least accurate and electrocardiogram being the most accurate. More research is needed on Doppler ultrasound before its clinical use.
authors.affiliation: Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Alta., Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Phillipos
authors.forename: Anne Lee
authors.initials: AL
authors.lastname: Solevåg
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pichler
authors.forename: Khalid
authors.initials: K
authors.lastname: Aziz
authors.forename: Sylvia
authors.initials: S
authors.lastname: van Os
authors.forename: Megan
authors.initials: M
authors.lastname: O'Reilly
authors.forename: Po-Yin
authors.initials: PY
authors.lastname: Cheung
authors.forename: Georg M
authors.initials: GM
authors.lastname: Schmölzer
mesh_terms: D006334:Heart Function Tests / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn / Q000502:physiology*; D015997:Neonatal Screening; D012151:Resuscitation