FETOSCOPE

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FETOSCOPE
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• Starting around 20 weeks the fetal heart beat can
  be heard without doppler amplification
  (ultrasound)
• Best heard over the babys back
• uterus will feel firm
• A special stethescope called a fetoscope may be
  used

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May Be Difficult If

• Mother is overweight
• Placenta is in front of the uterus
• Always easier later on in pregnancy

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Preparation

• Let the mom empty her bladder
• Be sure the room is quiet
• Woman is supine
• If more than 28 weeks pregnant
• place a small rolled towel under R hip
• tilts her slightly to one side

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• Padded cone just above the pubic bone
• Headpiece solid against the forehead
• Exert a little pressure
• Slowly rotate it 360 degress
• Until you hear the heart beat

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• If nothing is heard
• Move the instrument
• 1 cm at a time
• up toward the umbilicus
• Rotate the instrument at each new position
• must be directed at the babys heart

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• If you have not heard the heart beat when you
  reach a position half-way between the pubic bone
  and the umbilicus
• Move 1cm to the side of midline
• Proceed back down to the pubic bone

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• If FHTs still not heard
• Do the same on the other side
• Again, 1 cm at a time
• Rotate the instrument at each new position

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Fetal Heart Rate

• Count the FHTs for 15 seconds
• Multiply by 4
• ( ) x 4 ___ per minute

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Where will you hear the heartbeat?

• See Figure 17-43

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Best heard over the back.