I too have always taught listen with a pinards first for the reasons
others have mentioned. To address your question of why is it different
to listening with a doppler or ultrasound transducer - I am not sure
whether it is still the case but at one time the CTG monitors had
transducers that would pick up anything in their range and work to
create a fetal heart - even where there wasn't one. Hence the apparent
CTG recordings where the baby had died. The inference was that this was
less likely to happen with a hand held doppler because the diameter of
the transducer is smaller - so this might be better!! However I don't
know of any documented information to this effect.
I also know that for some time, and it might still be the case, there
was at least one hospital in Ireland where the midwife listened in with
a pinard every 15mins even when the CTG was running.
The fundamental issue is the need to retain the skills of listening with
a pinard and giving credit to this as a viable means of identifying and
auscultating a fetal heart in addition to the use of other technologies
as appropriate.
Best wishes to all
Mary
-----Original Message-----
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]] On Behalf Of Sheila
Stewart
Sent: 25 April 2010 21:27
To: [log in to unmask]
Subject: ascultation of FHR prior to attaching CTG
Hi,
I am trying to find evidence of why the FHR should be ascultated by a
hand held doppler/sonicaid or pinnards before applying the ultrasound
transducer when attaching a fetal monitor. Why is asculating with an
ultrasound doppler/sonicaid so different from ascultating with the U/S
transducer of a EFM? It is the policy on the unit I work on to take the
maternal pulse and doucment it when attaching EFM to differentiate FHR
from maternal pulse. I would appreciate any information on this.
Thanks
Sheila
(midwife, North Wales)
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