Fetal Monitoring in the Prehospital Setting

Background: Prehospital emergency care providers have very little information regarding fetal perfusion adequacy in the field. Objective: This study was conducted to evaluate the feasability of the use of fetal monitoring in the prehospital setting. Methods: A mobile cardiotocometer was used for all consecutive pregnant women managed by our physician-staffed Emergency Medical Services unit. The visualization of interpretable tracings (both fetal heart rate and tocography) at the different stages of prehospital management was evaluated. Any change in a patient's management was also recorded. Results: There were 145 patients enrolled during 119 inter-hospital transfers and 26 primary prehospital interventions. Interpretable tracings were obtained for 81% of the patients during the initial examination. This rate decreased to 66% during handling and transfer procedures. For 17 patients (12%), the monitoring led to a change in the patient's management. Conclusion: This study shows that cardiotocography can be easily performed in the prehospital setting, and is usually feasible. Moreover, the study demonstrates a positive impact of fetal heart rate monitoring on prehospital management.