The nurse assisted Mrs. Donna to a dorsal recumbent position and is about to assess the fetal heart rate (FHR). Which of the following apparatus should the nurse use in auscultating for the FHR?
a- Doppler apparatus
b- Fetoscope
c- Ultrasound
d- Stethoscope
Answer: A.
Mrs. Donna’s gestational age is 16 weeks (4 months). During this time, the fetal heart rate is audible with a Doppler apparatus. A fetal heart beat can be detected with a Doppler apparatus starting at 12 weeks AOG. By 8 weeks AOG, fetal heartbeat can be detected with an ultrasound. A fetal heart beat is detectable with fetoscope by the 20th week AOG. (Source: Foundations of Maternal-Newborn Nursing by Murray and McKinney/Saunders 4th Ed).
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Invented by Edward H. Hon1 in 1958, a Doppler fetal monitor or Doppler heart rate monitor is a handheld / portable ultrasound transducer used to detect a fetus's heartbeat during prenatal care. Use the Doppler effect to provide an audible heartbeat simulation. Some models also show heart rate in beats per minute. The use of this monitor is sometimes known as Doppler auscultation.
A fetal Doppler monitor provides information about the fetus similar to the information provided by a fetal stethoscope. An advantage of the fetal Doppler monitor over a fetal (non-electronic) acoustic stethoscope is the production of sounds; which allows people, apart from the user, to listen to the beats. A disadvantage is its complexity and cost, and its low reliability for an electronic device.
Originally created for use by health professionals, their personal use is now becoming popular.
Fetal Heart Rate:
DopplerSonographyBloodFlowDiagram-de.svg
Beginning in the fifth (5) week the fetus's heart will accelerate at a rate of 3.3 beats per day for the next month.
The heart of the fetus begins to beat at approximately the same rate as that of the mother, which is 80 to 85 bpm. The fetal heart rate for weeks 5 through 9 is illustrated below, assuming an initial heart rate of 80:
- Week 5 starts at 80 and ends at 103 bpm
- Week 6 starts at 103 and ends at 126 bpm
- Week 7 starts at 126 and ends at 149 bpm
- Week 8 starts at 149 and ends at 172 bpm
- At week 9 fetal beats tend to beat within the range of 148 to 160 bpm.
The fetal heart rate will begin to decrease and will generally drop to position within the range of 110 to 160 bpm for week 12.2
Gender Prediction:
The evidence indicates that there is no relationship between the fetal heart rate and the gender of the fetus, therefore the heart rate cannot be used as a reliable predictor of the fetus gender.
Types of Dopplers:
Dopplers for home or hospital use differ in the following:
- Manufacturers:
Among the most popular manufacturers we have Nicolet, Huntleigh and Summit Doppler.
- Probe type:
waterproof or not. Waterproof probes are used in water births.
- Frequency:
2 or 3 MHz probes. It is advisable to use a 3 MHz probe to detect the heart rate at the beginning of pregnancy (8-10 weeks gestation). A 2 MHz probe is recommended for pregnant and overweight women.
- Heart rate display:
some Dopplers automatically show heart rate; others require that the heart rate be counted and timed by the doctor.
The use of “Sonicaid” as a common term to refer to a fetal Doppler monitor originated from the products of Sonicaid Ltd, a company located in West Sussex in the United Kingdom. Sonicaid products include the D205 / 206 portable fetal dopplers and the FM2 / 3/4 series of fetal monitors. The company was acquired by Oxford Intruments in 1987 to form Oxford Sonicaid. In 2006 the products and the Sonicaid brand was acquired by the British group Huntleigh Healthcare.
Uses of the adult Doppler fetal monitor:
Using a continuous 2 MHz Doppler, similar to that used in obstetrics for auscultation of fetal beats, it is possible to auscultate valvular movements and blood flows in the adult heart. This technique, recently developed by Mc Loughlin MJ and Mc Loughlin S, allows to explore undetectable phenomena to classical auscultation with a stethoscope and has demonstrated a superior sensitivity in the diagnosis of aortic valvulopathies and alterations in the diastolic relaxation of the left ventricle.
Because the physical basis of Doppler auscultation differs from those of the classic stethoscope, it has been suggested that both methods can be supplemented by improving the diagnostic yield of the cardiovascular physical exam.
a- Doppler apparatus
b- Fetoscope
c- Ultrasound
d- Stethoscope
Answer: A.
Mrs. Donna’s gestational age is 16 weeks (4 months). During this time, the fetal heart rate is audible with a Doppler apparatus. A fetal heart beat can be detected with a Doppler apparatus starting at 12 weeks AOG. By 8 weeks AOG, fetal heartbeat can be detected with an ultrasound. A fetal heart beat is detectable with fetoscope by the 20th week AOG. (Source: Foundations of Maternal-Newborn Nursing by Murray and McKinney/Saunders 4th Ed).
---------------------
Invented by Edward H. Hon1 in 1958, a Doppler fetal monitor or Doppler heart rate monitor is a handheld / portable ultrasound transducer used to detect a fetus's heartbeat during prenatal care. Use the Doppler effect to provide an audible heartbeat simulation. Some models also show heart rate in beats per minute. The use of this monitor is sometimes known as Doppler auscultation.
A fetal Doppler monitor provides information about the fetus similar to the information provided by a fetal stethoscope. An advantage of the fetal Doppler monitor over a fetal (non-electronic) acoustic stethoscope is the production of sounds; which allows people, apart from the user, to listen to the beats. A disadvantage is its complexity and cost, and its low reliability for an electronic device.
Originally created for use by health professionals, their personal use is now becoming popular.
Fetal Heart Rate:
DopplerSonographyBloodFlowDiagram-de.svg
Beginning in the fifth (5) week the fetus's heart will accelerate at a rate of 3.3 beats per day for the next month.
The heart of the fetus begins to beat at approximately the same rate as that of the mother, which is 80 to 85 bpm. The fetal heart rate for weeks 5 through 9 is illustrated below, assuming an initial heart rate of 80:
- Week 5 starts at 80 and ends at 103 bpm
- Week 6 starts at 103 and ends at 126 bpm
- Week 7 starts at 126 and ends at 149 bpm
- Week 8 starts at 149 and ends at 172 bpm
- At week 9 fetal beats tend to beat within the range of 148 to 160 bpm.
The fetal heart rate will begin to decrease and will generally drop to position within the range of 110 to 160 bpm for week 12.2
Gender Prediction:
The evidence indicates that there is no relationship between the fetal heart rate and the gender of the fetus, therefore the heart rate cannot be used as a reliable predictor of the fetus gender.
Types of Dopplers:
Dopplers for home or hospital use differ in the following:
- Manufacturers:
Among the most popular manufacturers we have Nicolet, Huntleigh and Summit Doppler.
- Probe type:
waterproof or not. Waterproof probes are used in water births.
- Frequency:
2 or 3 MHz probes. It is advisable to use a 3 MHz probe to detect the heart rate at the beginning of pregnancy (8-10 weeks gestation). A 2 MHz probe is recommended for pregnant and overweight women.
- Heart rate display:
some Dopplers automatically show heart rate; others require that the heart rate be counted and timed by the doctor.
The use of “Sonicaid” as a common term to refer to a fetal Doppler monitor originated from the products of Sonicaid Ltd, a company located in West Sussex in the United Kingdom. Sonicaid products include the D205 / 206 portable fetal dopplers and the FM2 / 3/4 series of fetal monitors. The company was acquired by Oxford Intruments in 1987 to form Oxford Sonicaid. In 2006 the products and the Sonicaid brand was acquired by the British group Huntleigh Healthcare.
Uses of the adult Doppler fetal monitor:
Using a continuous 2 MHz Doppler, similar to that used in obstetrics for auscultation of fetal beats, it is possible to auscultate valvular movements and blood flows in the adult heart. This technique, recently developed by Mc Loughlin MJ and Mc Loughlin S, allows to explore undetectable phenomena to classical auscultation with a stethoscope and has demonstrated a superior sensitivity in the diagnosis of aortic valvulopathies and alterations in the diastolic relaxation of the left ventricle.
Because the physical basis of Doppler auscultation differs from those of the classic stethoscope, it has been suggested that both methods can be supplemented by improving the diagnostic yield of the cardiovascular physical exam.
Labels
gynecology - Obstetrics