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Intrapartum fetal heart rate assessment: monitoring by auscultation or electronic means

Article Abstract:

Monitoring fetal heart rate by auscultation does not appear suitable for busy labor and delivery rooms. Auscultation is listening to body sounds, usually with a stethoscope. The American College of Obstetricians and Gynecologists (ACOG) has recommended the use of either electronic heart rate monitoring during labor or auscultation of the fetal heart for 60 or more seconds every 15 minutes in the first stage of labor and every five minutes in the second stage. Of 862 pregnant women in labor, auscultation was begun as the main method of fetal monitoring in 423. Auscultation could not be initiated in 420 because there were not enough nurses available, in 12 because they were obese and in 7 because they refused. Auscultation was stopped before delivery in 392 of the 423 women. In almost all cases, auscultation was stopped because nurses either could not auscultate or record the results as often as the ACOG criteria demanded.

Methods, Evaluation, Heart, Fetal heart rate monitoring, Electronic fetal monitoring, Auscultation, Heart sounds

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Incidence of adverse cardiopulmonary effects with low-dose continuous terbutaline infusion

Article Abstract:

Drug treatment to prevent preterm labor using low doses of terbutaline administered beneath the skin but not intravenously may not be associated with heart attacks or breathing cessation. Intravenous administration of beta-adrenergic receptor agonist agents such as terbutaline have been reported to cause death in pregnant women. Researchers reviewed the records of 8709 women with preterm labor who had been prescribed low dose subcutaneous (beneath the skin) terbutaline and found that 47 women (0.54%) experienced heart or lung complications. Two deaths occurred in a larger group of 24,406 women but neither was found to have been caused by terbutaline. Low, continuous doses of terbutaline may prevent labor and cardiovascular problems.

Care and treatment, Complications and side effects, Premature labor, Terbutaline

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