A retrospective audit by the Queensland Maternal and Perinatal Quality Council has identified potential risks associated with the use of home fetal heart monitors in pregnancy.
The audit identified four clinical incidents involving the use of fetal dopplers at home which saw women, concerned about a lack of fetal movement, being falsely reassured about their baby’s heart rate.
The Therapeutic Goods Administration (TGA) is investigating.
Professor Ted Weaver, Co-Chair of the QMPQC and Senior Medical Officer Obstetrics and Gynaecology at the Sunshine Coast University Hospital, said in the wrong hands home fetal dopplers could be easily misinterpreted. “Dopplers only provide a snapshot of the heart rate and do not indicate whether the baby is healthy or not. In untrained hands, it is difficult to accurately obtain a fetal heart rate.”
Prof Weaver said the four clinical incidents included three stillbirths and one baby dying shortly after birth.
As a result of the audit, CEQ’s Patient Safety and Quality Improvement Service released a patient safety communique last week to flag the issue with clinicians (available on QHEPS).
“We should be cautioning expectant parents about the potential risks of using home fetal dopplers.”
Prof Weaver said fetal movement should be discussed with women early on in pregnancy and recommended the consumer Safer Baby Bundle resources.
“Every woman’s perception of fetal movement is different and movement patterns can vary between pregnancies and throughout pregnancy.”
“Women should be reminded at each scheduled and unscheduled antenatal visit — especially after 28 weeks’ gestation — of the importance of being aware of fetal movements and to report any concerns of a decrease in strength and/or frequency,” he said.
Prof Weaver reiterated the need for concerns to be taken seriously. “Women who raise concerns around fetal movements should immediately attend a health service for assessment Their concerns override any low-risk pregnancy status or other factors.”
“Presentations for fetal movement should not be delayed, for example, to try and stimulate the baby through food or drink. It is recommended they are assessed within two hours of presenting.”
Decreased fetal movement is a key element of the Safer Baby Bundle which is designed to reduce preventable stillbirths across the country. All maternity sites in Queensland are participating.
A type of home fetal heart rate doppler