Re: OB:Home Births in Australia

From: Braun, R. Daniel (rbraun@iupui.edu)
Mon Aug 31 06:22:56 1998


Using a doppler is not "the process of listening for sounds within the body" The doppler actually detects motion within the body and presents this to us a sound. Ergo Doppler is not auscultation. Since the studies were done with real "auscultation" with a fetal stethoscope, I believe that is what everyone is talking about. Actually the doppler with a readout is probably more accurate than auscultation. Studies done in the early 70's showed that professionals listening to tapes of fetal heart sounds and counting them were not very accurate at all especially if the heart rate was above 150 or below 130. The errors were frequently in the range of 50 BPM. Dan

-----Original Message----- From: wilsonk@gtn.net [SMTP:wilsonk@gtn.net] Sent: Sunday, August 30, 1998 11:52 AM To: Multiple recipients of list Subject: Re: OB:Home Births in Australia

At Sat, 29 Aug 1998, R L Meisel wrote: >

>Kathi,
>
>Perhaps I'm being a pain but...
>
>Your description of fetal monitoring is intermittent EFM ie
doppler with >automatic rate read out. The only difference is you don't have
a "strip" to >record for you. Ascultation is listening with a fetoscope.

Hmm...my Taber's states that "Auscultation is the process of listening for sounds within the body.." It doesn't define with what one listens. In the sense that I don't have earpieces in my ears, I guess I'm not "auscultating". That being said, I do have to say that my hearing takes precedence over the readout when using a doppler. They are not always accurate (same problems as external monitors), and if I am in question, I count.

I do listen prenatally with my elegant little Allen fetoscope as a means of confirming position and presentation, but most labouring women prefer the freedom of movement that listening with the doppler gives them. I think that "true" ausculation with a fetoscope is becoming a lost art.

I think that probably the SOGC and ACOG are referring to dopplers in their use of the term auscultation, but your point is well taken.

-- Kathi Wilson BHSc RM Thames Valley Midwives London, Ontario, Canada mailto:wilsonk@gtn.net





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