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PubMed1999

[Physical diagnostics--auscultation of fetal heart sounds].

Auscultation or recording of foetal heart tones is possible throughout pregnancy. In the first trimester, the presence of heart activity proves a vital pregnancy and reduces the probability of spontaneous abortion. From the end of the second and during the whole of the third trimester foetal heart activity can be used to asses the foetal condition. The introduction of cardiotocography failed to reduce serious perinatal morbidity or mortality as compared with intermittent auscultation, but did increase the number of obstetrical interventions.

Adult↗
PubMed1991

Electronic fetal heart monitoring, auscultation, and neonatal outcome.

In a large randomized, controlled study of fetal heart rate monitoring with either continuous electronic fetal heart monitoring or auscultation at specified intervals, only one pattern of deviation in the fetal heart rate correlated significantly with neonatal neurologic examinations at 0 to 48 hours and 72 hours to 1 week: late decelerations in stage 1 and in stage 2. Other variables from labor and delivery, specifically, duration of labor after hospital admission, failure of labor to progress, number of fetal scalp pH values, and presence of meconium were important predictors of neonatal outcome in the regression analyses. The fetal heart rate deviations did contribute significantly to the percent variance accounted for in the regression analyses with neonatal outcomes of Apgar scores at 1 and 5 minutes and serial neonatal neurologic examinations.

Apgar Score↗
PubMed2006

[Heart murmur--auscultation or echocardiography in the diagnostic assessment of congenital or valvular heart disease?].

The incidence of patients with degenerative valvular but also of patients with congenital heart disease surviving until adulthood or even old age will increase in the next decades. Auscultation with the stethoscope remains an important diagnostic means in the detection and treatment of heart disease. Heart murmurs (especially systolic heart murmurs) are extremely common. There are helpful clues to differentiate heart murmurs. It can occasionally be relatively simple to differentiate a systolic murmur due to valvular heart disease from an innocent, ejection murmur; however, there are important limitations of auscultation. Overall, auscultation and clinical examination alone do not suffice to correctly diagnose and treat patients with heart failure or a murmur Clinically significant aortic stenosis, aortic regurgitation and mitral regurgitation as well as hypertrophic cardiomyopathy are not uncommonly missed or misinterpreted. An echocardiographic exam is mandatory in all patients with more than a soft systolic murmur, any diastolic murmur, cardiac symptoms and/or ECG changes.

Auscultation↗
PubMed1988

Auscultated fetal heart rate accelerations. III. Use of vibratory acoustic stimulation.

The auscultated acceleration test has been proposed as a simple, inexpensive screening test for fetal health; previous studies of the auscultated acceleration test used external stimulation to elicit fetal movement. This study was conducted to explore the ability of the auscultated acceleration test to predict nonstress test results when vibratory acoustic stimulation is used to elicit fetal reactivity. After antepartum nonstress testing on 100 gravid women between 28 and 43 weeks' gestation, a 6-minute auscultated acceleration test protocol was performed with two vibratory acoustic stimulations to the maternal abdomen if no spontaneous fetal heart rate acceleration occurred. The ability of the auscultated acceleration test to predict nonstress test results after selected variables were controlled for was as follows: sensitivity, 75%; specificity, 97.6%; false-positive results, 14.3%; and false-negative results, 4.7%. Logistic regression analysis indicated that, in addition to the auscultated acceleration test, gestational age and race contributed significantly to the prediction of nonstress test results. Although specificity and the false-positive rate were improved, the use of vibratory acoustic stimulations to elicit fetal movement did not improve the validity of the auscultated acceleration test in terms of sensitivity and false-negative results over previous studies. However, the auscultated acceleration test continues to show potential as an initial screening test for fetal assessment. In addition to recommendations for further research, methodologic issues related to sampling techniques are identified.

Acoustic Stimulation↗
PubMedDate not supplied

Fetal heart rate auscultation: current and future practice.

Intermittent auscultation (IA) has been reported as equivalent to electronic fetal monitoring (EFM) as a fetal surveillance method in terms of neonatal outcomes based on randomized controlled trials and meta-analyses. Despite recommendations to include IA as a primary method for fetal evaluation, EFM use predominates. Understanding the equipment, method, benefits and limitations, and strategies for implementing IA may assist nurses in providing informed choices for low-risk pregnant women.

Algorithms↗
PubMedDate not supplied

Auscultated fetal heart rate accelerations. An alternative to the nonstress test.

This nonexperimental, descriptive correlational study was conducted to determine whether a significant difference exists between the results of an electronically monitored nonstress test (NST) and those of auscultation for single fetal heart rate acceleration, the auscultated acceleration test (AAT). Of 130 NSTs, both the NST and the AAT were reactive in 105 cases and both were nonreactive in seven cases. Eighteen nonreactive AATs went on to have reactive NSTs (72.00% false-positive rate). There were no reactive AATs that went on to have nonreactive NSTs (0% false-negative rate). Various recommendations are made for future research in an attempt to decrease the false-positive rate. The McNemar's test for data analysis used in previous research indicated that there was a significant difference between the two tests. However, the sensitivity (100%) and specificity (85.37%) of the AAT indicate that the test is valid in predicting the results of the NST and thus appears to be a valid screening tool for fetal well-being and may be a reliable alternative to the NST.

Adolescent↗