Doctors are again warning 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.