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Auscultation Of The Fetal Heart

Listening to the fetal heart is of no known clinical benefit to midwives and doctors. However, it may be of psychological benefit to mothers.

Good Practice Notes

Women should be offered auscultation at each visit from the time midwives and doctors can detect a heartbeat.

Aim

The aim of these guidelines is to assist midwives and doctors regarding auscultation of the fetal heart during pregnancy.

Evidence

Listening for the fetal heart during pregnancy has been shown to have no clinical value to midwives and doctors, though it does confirm that the baby is alive. It is unlikely that decelerations will be heard during pregnancy and the variability or detailed fetal heart (1) rate pattern cannot be determined . Fetal movements felt on palpation or reported by the mother will confirm the fetus is alive, as will the use of ultrasound. However, midwives and doctors perceive auscultation is reassuring and enjoyable for mothers and therefore worthwhile, though there is no published evidence to support this view.

Methods of Search and Appraisal

I. General Literature Search ( March 2000)

The Centre for Clinical Effectiveness conducted a general search of electronic databases of antenatal monitoring of fetal heart in the Cochrane Library, Medline and CINAHL using the search terms fetal (foetal) monitoring, fetal (foetal) heart, fetal auscultation combined with prenatal care, antenatal and pregnancy. One article was retrieved of Level IV evidence.

II. Search on Defined Questions ( September 2000)

The lead person from the steering group used the same terms to conduct a search of Medline and Premedline (until August 2001) to answer:

  1. Does auscultation of the fetal heart offer any clinical benefits to pregnant women compared to no auscultation?
  2. Does auscultation of the fetal heart offer any psychological benefits to pregnant women compared to no auscultation?

One review was retrieved but did not directly answer the questions. The coordinator searched grey literature and journals for additional evidence published between October 2000 and August 2001 on Antenatal Care.

References

  1. Sharif K, Whittle M. 1993. Routine antenatal fetal heart rate auscultation: is it necessary? Journal of Obstetrics and Gynaecology. (13): 111-113. Level IV
  2. Feinstein NF. Fetal heart rate auscultation: current and future practice [Review, 49 refs]. Journal of Obstetrics, Gynaecology and Neonatal Nursing 2000;29(3):111-113. Level IV

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