Expectant mothers are being warned over the use personal monitors, such as Doppler devices, to listen to their baby’s heartbeat at home. There is concern that they may lead to delays in seeking assistance for reduced fetal movements.
Dr Thomas Aust and colleagues from the Department of Obstetrics and Gynaecology at Arrowe Park Hospital, Wirral, UK describe the case of a 27 year old woman in this week’s BMJ. She presented to their labor ward 32 weeks into her first pregnancy with reduced fetal movements.
Two days earlier, she had first noted a reduction in her baby’s activity. But she had used her own Doppler device to listen to the heartbeat and reassured herself that everything was normal.
Additional monitoring by the antenatal care team raised the alarm. The baby was delivered by caesarean section later that evening. The infant remained on the special care baby unit for eight weeks and is making steady progress.
The authors explain that a hand-held Doppler device assesses the presence of fetal heart pulsations only at that moment. It is used by midwives and obstetricians to check for viability or for intermittent monitoring during labor. In inexpert hands it is more probable that blood flow through the placenta or the mother’s main blood vessels will be heard.
Following this case, they searched the internet and found that a fetal Doppler device could be hired for £10 (about 16.46 USD) a month or bought for £25 to 50 (about 41 to 82 USD) (ebay.co.uk). The companies offering sales state that the device is not intended to replace recommended antenatal care. However, they also make claims such as “you will be able to locate and hear the heartbeat with excellent clarity” (hi-baby.co.uk).
The authors say: “It is difficult to say whether self monitoring altered the outcome in this case.” But now, there are posters in their antenatal areas advising patients not to use these devices.
“Caution with home fetal Doppler services”
Thomas Aust, David Ankers, Akin Famoriyo
BMJ 2009; 339:b3220