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Fetal Heart Tones - OB/GYN, Midwives, Women's Health Center-East/West (12.09)

Fetal Heart Tones - OB/GYN, Midwives, Women's Health Center-East/West (12.09) - Policies, Clinical, UWHC Clinical, Department Specific, Ambulatory, Clinic Specific

12.09

12.09 Fetal Heart Tones ‐ OB/GYN, Midwives, Women's Health Center‐East/West  
Category:  UWHC Departmental Policy   
Policy Number:  12.09    
Effective Date:  April 23, 2014   
Version:  Revision    
Manual:  Ambulatory    
Section:  Clinic Specific (Ambulatory)   
 
 
I. PURPOSE

To provide a process for the measurement of fetal heart tones.

II. DEFINITIONS

Fetal heart tones may be measured to obtain baseline data and to detect changes in the physical condition of the
fetus. Fetal heart tones are audible with a Doppler approximately 10 to 12 weeks after the patient's last menstrual
period.
A. Normal fetal heart tone rate is 110 to 160 beats per minute.
B. Bradycardia is less than 110 beats per minute.
C. Tachycardia is greater than 160 beats per minute.

III. POLICY

The clinical staff will utilize the following procedure to measure fetal heart tones.

IV. PROCEDURE
A. Explain procedure and purpose of measuring fetal heart tones to the patient.
B. Make the patient comfortable and help the patient to a supine position.
C. If available, examine the previous recording of the fetal heart rate.
D. Use Leopold’s maneuvers to locate the position of the fetus in the patient’s abdomen by gently palpating
the upper and lower borders of the uterus and the lateral borders of the uterus.
E. Using a Doppler to measure the heart tones:
1. Turn on the Doppler and gently move the wand along the skin of the patient’s abdomen.
2. Listen for the sound of blood flowing through the heart of the fetus.
3. Count the fetal heart rate for one full minute.
4. NOTE: If fetal heart rate is LESS THEN 110 beats per minute; compare fetal heart rate against
the patient’s apical heart rate to confirm you are not including the patient’s.
5. If fetal bradycardia or tachycardia is present, notify provider immediately.
6. Clean equipment with hospital-approved disinfectant.
F. Discuss the findings with the patient and family.
G. Record the fetal heart rate in patient’s electronic medical record.

V. REFERENCE


OB/GYN Peds Notes Nurse's Clinical Pocket Guide, Brenda Walters Holloway and Cheryl Moredich, F. A. Davis
Company, 2nd Edition, 2011
The American College of Obstetricians and Gynecologists, Clinical Practice Guidelines; Number 106; July 2009.

VI. WRITTEN BY

Clinic Manager, Womens Health Center
Clinic Coordinator, OB/GYN-West

VII. REVIEWED AND APPROVED BY

Gregory Bills, MD, Medical Director
Clinic Coordinator, OB/GYN – West Clinic
Ambulatory Policy and Procedure Committee
Clinics Administration

SIGNED BY

Deborah D. Tinker, MSN RN CENP, Director, Ambulatory Nursing