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Foetal heart rate monitors raise concern

Wednesday August 19th, 2009

By Jane Collingwood
A senior obstetrician has suggested that pregnant women should not use hand-held foetal heart monitors.

Dr Thomas Aust and colleagues from the Department of Obstetrics and Gynaecology at Arrowe Park Hospital, Wirral, UK, believes that the mother's heart beat can be mistaken for the baby's, leading to a delay in seeking help for reduced foetal movements.

On the website of the British Medical Journal, Dr Aust and colleagues report on the case of a 27-year old woman who was 32 weeks' pregnant. She arrived at the labour ward with reduced foetal movements, but had delayed taking action for two days after being reassured by her Doppler device.

The antenatal care team were concerned about the results of a foetal cardiotocograph, and carried out a caesarean operation that evening. The baby is making steady progress, but was on a special care baby unit for eight weeks.

The authors state that the National Institute for Health and Clinical Excellence does not support the routine counting of foetal movements, "but most obstetric units would encourage patients to attend for a cardiotocograph and possibly further ultrasound assessment of growth and foetal activity if episodes of reduced movements recur".

However, hand-held Doppler devices are more likely to pick up on blood flow through the placenta or the mother's blood vessels, in untrained hands.

"Although self monitoring provided false reassurance and a delay in seeking help in this case, it is difficult to say if this altered the outcome," the author write. "We now have posters in our antenatal areas to recommend that patients do not use these devices."

Aust, T., Ankers, D. and Famoriyo, A. Caution with home fetal Doppler devices. The British Medical Journal, 2009;339:b3220.

Tags: Childbirth and Pregnancy | Nursing & Midwifery | UK News | Women’s Health & Gynaecology

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