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BEWARE HOME FOETAL DOPPLER

21/08/2009

BEWARE HOME FOETAL DOPPLER

Patients consult their GP doctor in the surgery clinic regarding foetal doppler machine for home use. There is a report by doctors in Wirral regarding the use by a pregnant patient of home foetal Doppler machine. British Medical Journal BMJ 2009;339:b3220

A pregnant lady noticed reduced foetal activity but had used her own Doppler device to listen to the foetal heartbeat and reassured herself that everything was normal. However the hospital monitoring by foetal cardiotocograph was not reassuring. The baby was delivered by caesarean section later that evening, received special care and is making steady progress.

The current guidelines from the National Institute for Health and Clinical Excellence (NICE) on detection of fetal wellbeing do not support the routine counting of foetal movements, but most obstetric units would encourage patients to attend for a cardiotocograph and possibly further ultrasound assessment of growth and foetal activity if episodes of reduced movements recur. A hand-held Doppler device assesses the presence of foetal heart pulsations only at that moment, and it is used by midwives and obstetricians to check for viability or for intermittent monitoring during labour. In untrained hands it is more likely that blood flow through the placenta or the maternal aorta or iliac vessels will be heard.

An internet search revealed that a foetal Doppler device could be hired for £10 a month or bought for £25-50. Although the companies offering sales state that the device is not intended to replace recommended antenatal care, they also make claims such as "you will be able to locate and hear the heartbeat with excellent clarity" Although self monitoring provided false reassurance and a delay in seeking help in this case, it is difficult to say if this altered the outcome.

OPINION
We recommend that patients do not use these devices.

The 'Cardiff count to ten' method. If your baby has at least 10 movements (kicks) within a 12 hour period (say 6am-6pm) they are thought to be well. You should contact your doctor, midwife or hospital (for hospital monitoring) if in any doubt.

Dr Martin Harris
Private GP in London Tel 020 8209 2401
www.surgerydoor.co.uk/professionals/private-gp/private-gp-directory/?ent...


Written by Dr Martin Harris, Doctor and Mohel for Jewish Circumcision Clinic in London Bris Mila Brit Milah.
www.circumcisionlondon.co.uk

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