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Discussion

Prenatal Assessment Question

Hello to all OB nurses...I have a question. I work in a correctional facility, so I am not very experienced when it comes to obstetrical matters. We get pregnant inmates at times, however. Right now we have 2. My question is this: Can you hear a fetal heart rate with a stethoscope? Especially on a patient who is only 2 months along? There is a nurse that works with me that says you can and she even charts the HR. I find it HARD to believe. I, myself, have never auscultated a FHR with a stethoscope. I think she is hearing the abdominal aorta or the pulse of the placenta...it seems like I remember learning that the placenta had its own pulse or something like that (correct me if I am way out in left field!! Please forgive and remember my expertise is corrections!!) Anyway, I have asked some more experienced nurses at work and they say NO... I also asked some EMS people...one officer who has been an EMT for over 10 years and he says no he never has. Any info on the subject would be greatly appreciated.

Thanks!:nurse:

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Hello to all OB nurses...I have a question. I work in a correctional facility, so I am not very experienced when it comes to obstetrical matters. We get pregnant inmates at times, however. Right now we have 2. My question is this: Can you hear a fetal heart rate with a stethoscope? Especially on a patient who is only 2 months along? There is a nurse that works with me that says you can and she even charts the HR. I find it HARD to believe. I, myself, have never auscultated a FHR with a stethoscope. I think she is hearing the abdominal aorta or the pulse of the placenta...it seems like I remember learning that the placenta had its own pulse or something like that (correct me if I am way out in left field!! Please forgive and remember my expertise is corrections!!) Anyway, I have asked some more experienced nurses at work and they say NO... I also asked some EMS people...one officer who has been an EMT for over 10 years and he says no he never has. Any info on the subject would be greatly appreciated.

Thanks!:nurse:

Hello, in order to auscultate FHTs without a doppler, you would need a special type of stethoscope, called a fetoscope. It has an attachment where you place the (specially shaped) diaphragm on the abdomen and rest your head against a metal piece, the sound is conducted through the tubing to your ears, like a regular stethoscope.

Very, very rarely can you auscultate the FHR with anything before 10 weeks, let alone a stathoscope.

  • Admin

I might add here, if the gravida is very small, less adipose tissue and in the advanced stages of pregnancy, one might be able to auscultate the FHT with a stethoscope. However, in the scenerio you gave, crj, this would be impossible ...... too early in the pregnancy. Also, the placenta is not audible at that stage as well, for it is not developed.

In years past, when one could auscultate the FHT with the fetoscope, it was around 18-22 weeks. This also set the stage for "age of viability" or, when the examiner could actually hear the heart rate of the fetus with a scope. That was utilized (age of viability per FHT auscultation) in litigation cases when the mother died as well as the baby inutero. If it was before the FHT could be auscultated, normally the fetus was termed "non-viable" and this was given zero weight in the case.

I also might add, the old fetoscopes were one piece. The "bell" placed on the maternal abdomen and the remainder fit over the examiner's head. The sounds were conducted through the placement of the metal anterior/posterior of the examiner head......frontal bone to occipital bone. There were other types where the diaphragm was a huge piece of thick metal attached to the tubing and traditional ear pieces.

  • Author

Thanks so much for the replies. Okay...a fetoscope, that is what it's called. I thought I remembered seeing something like that, couldn't remember the name of it! Since we do not have a fetoscope at the jail, I am sure that the FHR is NOT being detected by this nurse. And thanks Siri, for info on placenta. This is very interesting. Again, thanks for all the replies. I will share this info at work!:clown:

crjnursewarrior:)

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