Fetal heart rate pattern recognition by the method of auscultation

The thesis that obstetric health care personnel can discriminate characteristics of baseline fetal heart rate (FHR) and FHR patterns by auscultation needs to be tested. For this study, audiotones of the FHR signals were recorded for eight representative FHR patterns. Each recording was for three minutes and included one uterine contraction. Physicians and nurses who use continuous electronic FHR monitoring on a regular basis listened to the eight recordings and attempted to identify the baseline rate, variability, and periodic patterns, and then matched their perceptions with the eight corresponding FHR tracings (not in order). Baseline FHR and FHR without periodic patterns were most frequently identified correctly. Late decelerations with and without good baseline variability were misdiagnosed 18.4 and 33% of the time, respectively. Although the FHR characteristics and periodic patterns were correctly identified most of the time, failure to recognize significant periodic patterns by as many as one-third of the participants is unacceptable in modern obstetrics.