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ABSTRACT

This study was conducted to assess interobserver reliability in auscultating the fetal heart rate (FHR) with a fetoscope and to assess the ability to accurately document FHR accelerations by auscultation. A data collection graph was developed that was useful in graphic representation of FHR accelerations and in comparing auscultated with monitored accelerations. Three pairs of certified nurse-midwife (CNM) investigators auscultated FHRs simultaneously with a fetoscope. The correlation coefficients were 0.80, 0.80, and 0.90. These values indicated that these CNMs could reliably hear the same FHRs when auscultating simultaneously. Twenty-nine FHR tracings recorded by Corometrics 112 and Litton FM 660 monitors were examined. In 28 cases an auscultated FHR acceleration accurately corresponded with each monitored acceleration. In one case, subtle, low-amplitude accelerations were recorded by electronic monitoring but not auscultated. The results suggest that: 1) there can be interobserver reliability when auscultating the FHR with a fetoscope, and 2) FHR accelerations can be accurately auscultated. These findings, along with the data collection graph, form the basis of simple means of documenting FHR accelerations. Further studies will be done to evaluate the occurrence of a single auscultated acceleration compared with the results of the electronically monitored nonstress test.