Fetal monitoring in the prehospital setting

J Emerg Med. 2010 Nov;39(5):623-8. doi: 10.1016/j.jemermed.2008.05.020. Epub 2008 Dec 5.

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 feasibility 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.

MeSH terms

  • Adolescent
  • Adult
  • Cardiotocography*
  • Emergency Medical Services*
  • Feasibility Studies
  • Female
  • Fetal Monitoring* / statistics & numerical data
  • Humans
  • Middle Aged
  • Pregnancy
  • Prospective Studies
  • Young Adult