Also, the doctor should be in an uncomfortable position when he tries to pick out the faint sound of beats over ambient noises.
Moreover there is the possibility of confusing the fetal heartbeat with the heartbeat of the mother especially when she is tachy. Furthermore, the Placental breath, a noise from the circulation of blood in the villous rooms, could be heard during the auscultation.
Finally, and to illustrate the practical problems that the Pinard Horn shows are:
This monitoring, in practical point of view, can only be discontinuous.
then auscultation is impossible to achieve within the uterine contractions, and yet it is essential to analyze the changes in the frequency of fetal heart rate during contractions because some slowdowns
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This method is used for measuring mechanical activity of the heart like the opening and closing movement of valves during each cardiac cycle to estimate the fetal heart rate signal. (10) It uses ultra-sounded technology by bouncing sound waves off the baby and return a representation of the fetal heartbeat rate (3). It depends on generating ultrasound beam with frequency of 1 or 2 MHz (the most common frequency are used in the range (1-2.3MHz). (11)
Although, it’s intended for use by health care professionals, it’s becoming more and more popular for personal uses. However, the FDA recommends against their home use, citing possible harm to a developing fetus. Although, doctors claim that till now there are lack of evidence that the ultrasound technology may cause risks for the health of either the mother or the fetus, they recommend a prudent use of it. (12)
Furthermore, this device, comparing to the last cited ones, is more expensive and less reliable. Some specific devices can be used after eight weeks of pregnancy. But 12 weeks is the normal time. The sound is looks like that of galloping horses.
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First, external cardiotocography is used for continuous or periodical monitoring of the fetal heart rate and the activity of the uterine muscle. The latter is detected by two transducers placed on the maternal abdomen: one above the fetal heart level and the other at the fundus. Doppler ultrasound provides the information which is recorded on a paper strip known as a cardiotocograph (CTG) (14) .The second type is the internal cardiotocograph uses an electronic transducer connected directly to the fetal scalp.
Internal monitoring provides a more accurate and consistent transmission of the fetal heart rate than external monitoring because factors such as movement do not affect it. Internal monitoring may be used when external monitoring of the fetal heart rate is inadequate, or closer surveillance is needed. (15)
It’s also an ultrasound based technology, the monitoring is done during pregnancy, labor, and delivery to keep track of the heart rate of your baby (fetus) and the strength and duration of the contractions of your uterus. (16) This is not always a benefit for women and their families. (3)
CTG machine provides graphical printed data. On the graph, there are two lines. The top line shows the fetal heart rate over time: the x-axis of the graph represents the elapsed playing time, while the y axis represents the instantaneous fetal heart rate. The bottom line shows uterine