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    Add as Friendfetal heart auscultation

    by: manamohan

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    1 : Auscultation Manamohan.N
    2 : Helps in diagnosis of a live baby Its location of maximum intensity can resolve doubt about the presentation of fetus
    3 : Fetal Monitoring Equipment Fetal heart rate (FHR) can be determined by use of: Fetoscope or Leff scope specifically designed instruments Clinical stethoscope Electronic Doppler
    4 : Doppler Method Employs a continuous ultrasound Can detect the fetal heart at 10-12 weeks’ gestation Amplifiers allow both the practitioner and parents to hear
    5 : Fetoscope Has a band that fits against the head of the listener makes handling of the instrument unnecessary aids in bone conduction of sound Can pick up the fetal heart rate at 17-19 weeks’ gestation
    6 : Fetal heart tones are best heard over the baby’s back Used in conjunction with Leopold’s maneuver Auscultation may be difficult if… Mother is overweight Placenta is in the front of the uterus *Always easier in later stages of the pregnancy
    7 : Best audible through the scapular border in vertex and breech presentation where convex portion of the back is in contact with the uterine wall In face presentation heart sounds are through fetal chest
    8 : Let her empty her bladder Be sure the room is quiet Place the mother supine for listening: Place the microphone on the abdomen and move in slow circles until the FHT are heard Place the padded cone just above the pubic bone Headpiece solid against the forehead Exert slight pressure into the abdomen Slowly rotate the cone 360 degrees, looking for the heart tones
    9 : Count for a minute. Repeat as you repeat the maternal vital signs. Early pregnancy listen in the midline between the symphysis pubis and the umbilicus. Late pregnancy listen in the right or left upper quadrant. sleeping = slower HR moving = faster HR
    10 : Fetal heart tones (FHT) may be heard 12 to 14 wks with a Doppler or handheld ultrasound or by a Fetoscope or a stethoscope by 18-20 wks. Normal FHT range is 120 to 160 beats per minute. Brief rate changes are normal during fetal movement, sleep and contractions. Locating the FHT may be difficult. Most often other tasks take priority.
    11 : Normally maximum intensity of FHS is Below umbilicus in cephalic presentation Around umbilicus in breech
    12 : In different vertex presentation Depends on position of back Degree of descent of head
    13 : Occipito anterior – middle of spino umbilical line on same side LOA – middle of left spino umbilical line ROA – middle of right spino umbilical line Occipito lateral – more lateral Occipito posterior – mothers flank on same side ROP – right flank LOP – left flank (most difficult)
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    17 : Internal heart rate monitoring Can only be done once "water has broken” Cervix has been fully dilated. A small clip is placed on the baby’s scalp to directly monitor the fetal heart rate. more accurate and consistent transmission of the fetal heart rate than external monitoring because factors such as movement do not affect it.
    18 : Figure 16–8 Electronic fetal monitoring by external technique. The tocodynamometer (“toco”) is placed over the uterine fundus. The toco provides information that can be used to monitor uterine contractions. The ultrasound device is placed over the area of the fetal back. This device transmits information about the fetal heart rate. Information from both the toco and the ultrasound device is transmitted to the electronic fetal monitor. The fetal heart rate is displayed in a digital display (as a blinking light), on the special monitor paper, and audibly (by adjusting a button on the monitor). The uterine contractions are displayed on the special monitor paper as well.
    19 : Thank you ?

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