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Evaluation of a simple method to assess fetal well-being in antenatal clinic
S Montan1, S Arulkumaran, S S Ratnam
1National University Hospital, National University of Singapore.
To study the feasibility of assessing fetal heart rate (FHR) acceleration by a fetal doptone and fetal movements (FM) as perceived by the mother and observed by the attendant in response to a vibroacoustic stimulus. Baseline FHR and it's response during the first minute after vibroacoustic stimulation was observed by a fetal doptone with a digital display on 317 occasions in 201 pregnancies (81.4% of whom were high risk) during antenatal visits in the third trimester. Fetal movements in response to the stimulus were recorded by the mother and the examiner. FHR increased 15 beats greater than the baseline rate for > 15 secs in 269 of the tests (83.4%), and fetal movements were observed by the mother in 301 (94.9%) of the tests. A FHR increase in > or = 15 bpm together with maternal and examiner perceived fetal movements were observed in 250 tests (81.7%). Good correlation was seen between the mother and the examiner (97.8%) of the observation of presence or absence of fetal movements to the vibroacoustic stimulus. One of the three parameters i.e. increase in FHR > or = 15 beats > or = 15 secs or perception of fetal movement either by the mother or the observer were present in 98.1% of the tests. If it could be considered that one of these three signs are indicative of good fetal health further investigations of fetal well-being would be needed in only 1.9%. The fetal outcome was uneventful in all pregnancies studied.(ABSTRACT TRUNCATED AT 250 WORDS)
To study the feasibility of assessing fetal heart rate (FHR) acceleration by a fetal doptone and fetal movements (FM) as perceived by the mother and observed by the attendant in response to a vibroacoustic stimulus. Baseline FHR and it's response during the first minute after vibroacoustic stimulation was observed by a fetal doptone with a digital display on 317 occasions in 201 pregnancies (81.4% of whom were high risk) during antenatal visits in the third trimester. Fetal movements in response to the stimulus were recorded by the mother and the examiner. FHR increased 15 beats greater than the baseline rate for > 15 secs in 269 of the tests (83.4%), and fetal movements were observed by the mother in 301 (94.9%) of the tests. A FHR increase in > or = 15 bpm together with maternal and examiner perceived fetal movements were observed in 250 tests (81.7%). Good correlation was seen between the mother and the examiner (97.8%) of the observation of presence or absence of fetal movements to the vibroacoustic stimulus. One of the three parameters i.e. increase in FHR > or = 15 beats > or = 15 secs or perception of fetal movement either by the mother or the observer were present in 98.1% of the tests. If it could be considered that one of these three signs are indicative of good fetal health further investigations of fetal well-being would be needed in only 1.9%. The fetal outcome was uneventful in all pregnancies studied.(ABSTRACT TRUNCATED AT 250 WORDS)