Auscultation

Question 1

When should an auscultation be undertaken?

Answer 1

• before the application of a CTG
• throughout labour to monitor the fetal response to labour
• to determine fetal life in the absence of movements
• upon maternal request.

Question 2

How do you auscultate using a Picard stethoscope

Answer 2

• Auscultation always follows a palpation
• Get permission from mother to go ahead
• fetal heart beat is normally best fount through the shoulder so palpating will help you locate this.
• position the Pinard over the area you believe is correct
• once positioned put your ear over the hole and remove your hands ensuring there is direct contact with the abdomen pinard and your ear
• listen and count the fetal heartbeat for 1 min
• discuss your results with the woman
• record them and act accordingly.

Question 3

How to auscultate using a Doppler devise?

Answer 3

• Auscultation will always follow palpation
• consent from mother
• Lubricate the Doppler ultrasound probe with conductive gel
• position the probe over where you think you’ll hear the heart beat.
• listen and count the heart beats for 1 min
• simultaneously palpate the maternal radial pulse to ensure your getting the fetal heart beat and not mums
• ensure woman about any other sounds heard (baby moving makes load sounds
• discuss results with mum
• document recordings and act accordingly

Question 4

Why are pinard stethoscopes used?

Answer 4

They are used to confirm the fetal heart rate is heard as some electrical equipment can confuse the fetal and maternal heart rate
Fetal heart rate can be heard from 24 weeks however most midwives don’t like to do it until week 28 because a smaller foetus that is moving lots is harder to stabilise.
Midwives hard of hearing wont use these

Question 5

Why are dollar ultrasounds used?

Answer 5

• electrical device that emints small high frequency waves wich reflect of the moving of the heart.
• allows mother and family to hear the heart beat
  We should always be alert to the absence of a fetal heart so we may choose to use a pinard stethoscope first so we can hear the heart rate
• the Doppler has to be held over the fetal heart often you can hear swooshing of the uterus and movements of the baby which will have to be explained to mum partner and family if they are present

Question 6

What is the range of a normal fetal heart?

Answer 6

110-160 BPM