Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital

Simple item page
dc.contributor.advisorFawcus, Susan Ren_ZA
dc.contributor.advisorWoods, Daviden_ZA
dc.contributor.authorChinula, Lamecken_ZA
dc.date.accessioned2014-07-28T14:48:30Z
dc.date.available2014-07-28T14:48:30Z
dc.date.issued2013en_ZA
dc.descriptionIncludes abstract.
dc.descriptionIncludes bibliographical references.
dc.description.abstractAlmost four million babies die in the first four weeks of life per year worldwide, most from preventable causes. In addition a million babies die during labour and delivery (Lawn J et al., 2005). In South Africa, ‘intrapartum hypoxia and birth trauma’ are among the top three causes of perinatal deaths. Severe intrapartum hypoxia is often preventable with appropriate maternal and fetal monitoring in labour. However, this remains a challenge in under-resourced settings, due to difficulties that accompany the use of a Pinard Fetal Stethoscope (PFS) which include user-dependence and lack of evidence based standardisation in taking measurements with it. Although intermittent fetal heart monitoring is as effective as continuous electronic monitoring in low risk labours (Banta DH and Thacker, 2001), the search is for reliable, robust and cheaper fetal monitoring devices. The innovative crank powered Doppler Ultrasound Fetal Heart Rate Monitor (DUFHRM) developed by Power-free Education and Technology is robust, cheaper and designed for use even in settings with no or erratic access to mains electricity and replaceable batteries, and overcomes some of the challenges that come with the use of PFS (Banta DH and Thacker, 2001). The aim of the study was to assess the accuracy of Fetal Heart Rates (FHRs)taken with the DUFHRM compared to FHRs taken with a PFS using a Cardiotocography (CTG) as a standard fetal heart rate monitoring device. This was a comparative diagnostic study conducted at Mowbray Maternity Hospital, a public sector maternity hospital in Cape Town during 2012. Women with singleton pregnancies in the active phase of the first stage of labour, who had consented to participation, were enrolled in the study. Paired readings of FHRs were taken with a DUFHRM and a PFS, by two midwives and also with a CTG during the active phase of the first stage of labour before and after two preferably consecutive uterine contractions. The midwives were blinded to the CTG measurements by silencing the CTG and turning it away from their view. The FHRs taken with a PFS were done over a 60 second period in accordance with the guidelines from professional bodies (ACOG, 1995, RANZCOG, 2002, RCOG, 2001a, Liston R et al., 2002) The DUFHRM and CTG readings were made at the start and end of each 60 second period of PFS monitoring. The proportion agreement of FHRs taken with a DUFHRM to FHRs recorded with a CTG, and the proportion agreement of FHRs taken with a PFS to FHRs recorded with a CTG were determined and compared using McNemar Exact Significance Probability test (mcc).en_ZA
dc.identifier.apacitationChinula, L. (2013). <i>Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. Retrieved from http://hdl.handle.net/11427/3038en_ZA
dc.identifier.chicagocitationChinula, Lameck. <i>"Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2013. http://hdl.handle.net/11427/3038en_ZA
dc.identifier.citationChinula, L. 2013. Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Chinula, Lameck AB - Almost four million babies die in the first four weeks of life per year worldwide, most from preventable causes. In addition a million babies die during labour and delivery (Lawn J et al., 2005). In South Africa, ‘intrapartum hypoxia and birth trauma’ are among the top three causes of perinatal deaths. Severe intrapartum hypoxia is often preventable with appropriate maternal and fetal monitoring in labour. However, this remains a challenge in under-resourced settings, due to difficulties that accompany the use of a Pinard Fetal Stethoscope (PFS) which include user-dependence and lack of evidence based standardisation in taking measurements with it. Although intermittent fetal heart monitoring is as effective as continuous electronic monitoring in low risk labours (Banta DH and Thacker, 2001), the search is for reliable, robust and cheaper fetal monitoring devices. The innovative crank powered Doppler Ultrasound Fetal Heart Rate Monitor (DUFHRM) developed by Power-free Education and Technology is robust, cheaper and designed for use even in settings with no or erratic access to mains electricity and replaceable batteries, and overcomes some of the challenges that come with the use of PFS (Banta DH and Thacker, 2001). The aim of the study was to assess the accuracy of Fetal Heart Rates (FHRs)taken with the DUFHRM compared to FHRs taken with a PFS using a Cardiotocography (CTG) as a standard fetal heart rate monitoring device. This was a comparative diagnostic study conducted at Mowbray Maternity Hospital, a public sector maternity hospital in Cape Town during 2012. Women with singleton pregnancies in the active phase of the first stage of labour, who had consented to participation, were enrolled in the study. Paired readings of FHRs were taken with a DUFHRM and a PFS, by two midwives and also with a CTG during the active phase of the first stage of labour before and after two preferably consecutive uterine contractions. The midwives were blinded to the CTG measurements by silencing the CTG and turning it away from their view. The FHRs taken with a PFS were done over a 60 second period in accordance with the guidelines from professional bodies (ACOG, 1995, RANZCOG, 2002, RCOG, 2001a, Liston R et al., 2002) The DUFHRM and CTG readings were made at the start and end of each 60 second period of PFS monitoring. The proportion agreement of FHRs taken with a DUFHRM to FHRs recorded with a CTG, and the proportion agreement of FHRs taken with a PFS to FHRs recorded with a CTG were determined and compared using McNemar Exact Significance Probability test (mcc). DA - 2013 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital TI - Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital UR - http://hdl.handle.net/11427/3038 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/3038
dc.identifier.vancouvercitationChinula L. Comparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospital. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2013 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/3038en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherObstetrics and Gynaecologyen_ZA
dc.titleComparability of an innovative Doppler ultrasound fetal heart rate monitor to a pinard fetal stethoscope using cardiotocography as a standard to assess the fetal heart rate in singleton pregnancies during labour at Mowbray Maternity Hospitalen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
thesis_hsf_2013_chinula_l.pdf
Size:
868.02 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters