Fetal heart rate auscultation: current and future practice

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Nursing Research

Background:

• Electronic fetal monitoring (EFM) is widely used for fetal surveillance.
• Randomized controlled trials and meta-analyses indicate intermittent auscultation (IA) is equivalent to EFM for neonatal outcomes.
• Despite evidence, EFM use remains predominant over IA.

Purpose of the Study:

• To compare the effectiveness of intermittent auscultation (IA) and electronic fetal monitoring (EFM) for fetal surveillance.
• To provide information on IA's equipment, methods, benefits, and limitations.
• To support nurses in making informed choices for low-risk pregnant women regarding fetal evaluation methods.

Main Methods:

• Review of randomized controlled trials (RCTs) and meta-analyses comparing IA and EFM.
• Analysis of neonatal outcomes associated with both IA and EFM.
• Synthesis of information regarding IA implementation strategies.

Main Results:

• Evidence suggests IA is non-inferior to EFM regarding neonatal outcomes.
• A significant disparity exists between IA recommendations and current clinical practice, with EFM predominating.
• Knowledge gaps may hinder IA adoption.

Conclusions:

• IA is a viable and effective alternative to EFM for low-risk pregnancies.
• Further education and implementation strategies are needed to promote appropriate use of IA.
• Nurses require comprehensive understanding of IA to offer informed choices to patients.