Selected topic: Prehospital care| Volume 39, ISSUE 5, P623-628, November 2010

Fetal Monitoring in the Prehospital Setting

Published:December 08, 2008DOI:


      Background: Prehospital emergency care providers have very little information regarding fetal perfusion adequacy in the field. Objective: This study was conducted to evaluate the feasability of the use of fetal monitoring in the prehospital setting. Methods: A mobile cardiotocometer was used for all consecutive pregnant women managed by our physician-staffed Emergency Medical Services unit. The visualization of interpretable tracings (both fetal heart rate and tocography) at the different stages of prehospital management was evaluated. Any change in a patient's management was also recorded. Results: There were 145 patients enrolled during 119 inter-hospital transfers and 26 primary prehospital interventions. Interpretable tracings were obtained for 81% of the patients during the initial examination. This rate decreased to 66% during handling and transfer procedures. For 17 patients (12%), the monitoring led to a change in the patient's management. Conclusion: This study shows that cardiotocography can be easily performed in the prehospital setting, and is usually feasible. Moreover, the study demonstrates a positive impact of fetal heart rate monitoring on prehospital management.


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        • Jones A.E.
        • Summers R.L.
        • Deschamp C.
        • Galli R.L.
        A national survey of the air medical transport of high-risk obstetric patients.
        Air Med J. 2001; 20: 17-20
        • Poulton T.J.
        • Gutierrez P.J.
        Fetal monitoring during air medical transport.
        J Air Med Transp. 1992; 11 (15–7): 13
        • Duchateau F.X.
        • Ricard-Hibon A.
        • Laribi S.
        • Chollet C.
        • Marty J.
        Feasibility of fetal monitoring in prehospital care.
        Ann Fr Anesth Reanim. 2005; 24: 831-832
        • Menthonnex E.
        • Menthonnex P.
        In utero medicalized transfers: medical regulation and transport process.
        J Gynecol Obstet Biol Reprod. 2003; 32: 157-168
        • Chollet C.
        • Ricard-Hibon A.
        • Marty J.
        Evaluation of check list for devices used in prehospital emergency medicine.
        JEUR. 1999; 12: 139-147
        • American Academy of Pediatrics
        Guidelines for perinatal care. 5th edn. American Academy of Pediatrics, Elk Grove Village, IL2002
        • Parer J.T.
        • King T.
        Fetal heart rate monitoring: is it salvageable?.
        Am J Obstet Gynecol. 2000; 183: 982-987
        • Vintzileos A.M.
        • Nochimson D.J.
        • Guzman E.R.
        • Knuppel R.A.
        • Lake M.
        • Schifrin B.S.
        Intrapartum electronic fetal heart monitoring versus intermittent auscultation: a meta-analysis.
        Obstet Gynecol. 1995; 85: 149-155
        • Sweha A.
        • Hacker T.W.
        • Nuovo J.
        Interpretation of the electronic fetal heart rate during labor.
        Am Fam Physician. 1999; 59: 2487-2500
        • Mahomed K.
        • Nyoni R.
        • Mulambo T.
        • Kasule J.
        • Jacobus E.
        Randomized controlled trial of intrapartum fetal heart rate monitoring.
        BMJ. 1994; 308: 497-500
        • Herbst A.
        • Ingermasson I.
        Intermittent versus continuous electronic monitoring in labour: a randomized study.
        Br J Obstet Gynaecol. 1994; 101: 663-668
        • Pearlman M.
        • Desantis K.
        • Schneider L.
        • Rupp J.
        • Moss S.
        • Ashton-Miller J.
        A comprehensive program to improve safety for pregnant women and fetuses in motor vehicle crashes: a preliminary report.
        Am J Obstet Gynecol. 2000; 182: 1554-1564
        • Schiff M.A.
        • Holt V.L.
        The injury severity score in pregnant trauma patients: predicting placental abruption and fetal death.
        J Trauma. 2002; 53: 946-949
        • El-Kady D.
        • Gilbert W.M.
        • Anderson J.
        • Danielsen B.
        • Towner D.
        • Smith L.H.
        Trauma during pregnancy: an analysis of maternal and fetal outcomes in a large population.
        Am J Obstet Gynecol. 2004; 190: 1661-1668
        • American College of Obstetricians and Gynecologists
        ACOG educational bulletin.
        Int J Gynaecol Obstet. 1999; 64: 87-94