Monitoring intrapartum fetal heart rates by mothers in labour in two public hospitals: an initiative to improve maternal and neonatal healthcare in Liberia.

BMC Pregnancy and Childbirth
K BorzieW Jallah

Abstract

In low-resource settings with few health workers, Fetal Heart Rate (FHR) monitoring in labour can be inconsistent and unreliable. An initiative to improve fetal monitoring was implemented in two public hospitals in rural Liberia; the country with the second lowest number of midwives and nurses in the world (1.007 per 10,000 of the population). The initiative assessed the feasibility of educating women in labour to monitor their own FHR and alert a midwife of changes detected. Four hundred seventy-four women admitted in labour without obstetric complications were approached. Four hundred sixty-one consented to participate (97%) and 13 declined. Those consenting were trained to monitor their FHR using a sonicaid for approximately 1 minute immediately following the end of every uterine contraction and to inform a midwife of changes. If changes were confirmed, standard clinical interventions for fetal distress (lateral tilt, intravenous fluids and oxygen) were undertaken and, when appropriate, accelerated delivery by vacuum or Caesarean section. Participants provided views on their experiences; subsequently categorized into themes. Neonatal outcomes regarding survival, need for resuscitation, presence of birth asphyxia, and treatme...Continue Reading

References

Oct 10, 2009·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Joy E LawnGary L Darmstadt
Oct 10, 2009·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·G Justus HofmeyrJoy E Lawn
Feb 19, 2013·Maternal and Child Health Journal·Jody R LoriCarol J Boyd
May 24, 2014·Lancet·Joy E LawnUNKNOWN Lancet Every Newborn Study Group
Jan 23, 2016·Lancet·Joy E LawnUNKNOWN Lancet Stillbirth Epidemiology investigator group
May 6, 2016·Bulletin of the World Health Organization·Obed DoloDavid P Southall
Apr 18, 2018·PloS One·Soo DowneA Metin Gülmezoglu

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