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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
Shashikant Sholapurkar
Royal United Hospital NHS Trust
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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.