Doctors renew warning over use of home fetal heart monitors
6 November 2009
Doctors have issued a further warning to expectant parents not
to use over-the-counter fetal heart monitors (Doppler devices) at home
because they can lead to false reassurance and delays in seeking medical
help.
This is the second case published by the BMJ this year and
highlights the tragic consequences these devices can have in untrained
hands.
Abhijoy Chakladar and Hazel Adams from the Princess Royal Hospital in
Haywards Heath, part of Brighton and Sussex University Hospitals NHS
Trust, describe the case of a 34 year old woman who presented to their
labour ward unable to detect her baby’s heartbeat with her fetal heart
monitor. She was 38 weeks pregnant with her first baby and was fit and
well, with no medical history.
The previous Friday she had noticed a reduction in her baby’s
movements but had reassured herself by listening to the “fetal”
heartbeat over the weekend. However, an urgent ultrasound scan showed no
fetal heart activity and intrauterine death was diagnosed.
Analysis of the fetal heart rate is commonly used during pregnancy
and labour to monitor the health of the fetus, explain the authors. But
in untrained hands it is more likely that blood flow through the
placenta or the mother’s own pulse will be heard.
After this experience, they searched the internet and were surprised
by the number of fetal heart monitors available. Although some retailers
state that the device should not replace medical supervision, they also
make claims such as “easy and safe to use to hear your unborn baby’s
heart beat”.
This death may have been unavoidable, but the use of a fetal heart
monitor certainly delayed presentation to hospital, say the authors.
They warn that monitors are for entertainment purposes only and can
be dangerous if used otherwise, and they call on manufacturers and
retailers to make the limitations of these devices absolutely clear.
They also suggest that obstetric services need to educate expectant
mothers about the limitations and the potentially fatal consequences of
untrained use of fetal heart monitors and to present clear guidance
about when to seek medical review.
An accompanying commentary outlines the concerns of several
organisations about the growing availability of these products in recent
years.