Intrapartum fetal heart rate monitoring using a handheld Doppler versus Pinard stethoscope: a randomized controlled study in Dar es Salaam

International Journal of Women's Health
Benjamin Anathory KamalaHege L Ersdal

Abstract

Fetal stethoscopes are mainly used for intermittent monitoring of fetal heart rate (FHR) during labor in low-income countries, where perinatal mortality is still high. Handheld Dopplers are rarely available and are dependent on batteries or electricity. The objective was to compare the Pinard stethoscope versus a new wind-up handheld Doppler in the detection of abnormal FHR. We conducted a randomized controlled study at Muhimbili National Hospital, Tanzania, from April 2013 to September 2015. Women with gestational age ≥37 weeks, cephalic presentation, normal FHR on admission, and cervical dilatation <7 cm were included. Primary outcome was abnormal FHR detection (<120 or >160 beats/min). Secondary endpoints were time to delivery, mode of delivery, and perinatal outcomes. χ2, Fisher's exact test, Mann-Whitney test, and logistic regression were conducted. Unadjusted and adjusted odds ratios were calculated with respective 95% confidence interval. In total, 2,844 eligible women were assigned to FHR monitoring with Pinard (n=1,423) or Doppler (n=1,421). Abnormal FHRs were more often detected in the Doppler (6.0%) versus the Pinard (3.9%) arm (adjusted odds ratio =1.59, 95% confidence interval: 1.13-2.26, p=0.008). Median (interqua...Continue Reading

Citations

Oct 28, 2019·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Marya PlotkinStephanie B Wheeler
Aug 31, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Shashikant L Sholapurkar
Jun 26, 2020·Physiological Measurement·Nasim KatebiGari D Clifford
Mar 17, 2020·Reproductive Health·Natasha HousseineMarcus J Rijken
Oct 27, 2020·Physiological Measurement·Camilo E ValderramaGari D Clifford

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Methods Mentioned

BETA
cesarean section
cesarean sections

Clinical Trials Mentioned

NCT01869582

Software Mentioned

Epidata
Freeplay
Openepi
Statistical Package for Social Sciences ( SPSS )

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