Abstract
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.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A national survey of the air medical transport of high-risk obstetric patients.Air Med J. 2001; 20: 17-20
- Fetal monitoring during air medical transport.J Air Med Transp. 1992; 11 (15–7): 13
- Feasibility of fetal monitoring in prehospital care.Ann Fr Anesth Reanim. 2005; 24: 831-832
- In utero medicalized transfers: medical regulation and transport process.J Gynecol Obstet Biol Reprod. 2003; 32: 157-168
- Evaluation of check list for devices used in prehospital emergency medicine.JEUR. 1999; 12: 139-147
- Guidelines for perinatal care. 5th edn. American Academy of Pediatrics, Elk Grove Village, IL2002
- Fetal heart rate monitoring: is it salvageable?.Am J Obstet Gynecol. 2000; 183: 982-987
- Intrapartum electronic fetal heart monitoring versus intermittent auscultation: a meta-analysis.Obstet Gynecol. 1995; 85: 149-155
- Interpretation of the electronic fetal heart rate during labor.Am Fam Physician. 1999; 59: 2487-2500
- Randomized controlled trial of intrapartum fetal heart rate monitoring.BMJ. 1994; 308: 497-500
- Intermittent versus continuous electronic monitoring in labour: a randomized study.Br J Obstet Gynaecol. 1994; 101: 663-668
- 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
- The injury severity score in pregnant trauma patients: predicting placental abruption and fetal death.J Trauma. 2002; 53: 946-949
- Trauma during pregnancy: an analysis of maternal and fetal outcomes in a large population.Am J Obstet Gynecol. 2004; 190: 1661-1668
- ACOG educational bulletin.Int J Gynaecol Obstet. 1999; 64: 87-94
Article info
Publication history
Published online: December 08, 2008
Accepted:
May 23,
2008
Received in revised form:
April 29,
2008
Received:
February 3,
2008
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
