fetal heart sound auscultation site

fetal heart sound ( FHS )  

fetal heartbeat gives information about the fetus lie, presentation & position inside the mother, and about the viability of fetus.

1st time Heartbeat is detected by Doppler transducer between 10 and 12 weeks during pregnancy.

1st time Heartbeat is detected by regular (nonelectronic) fetoscope 20 weeks during pregnancy.

auscultation site rule

• below umbilicus in all cephalic presentations.
• above umbilicus in all breech presentations.
• at or just above the umbilicus in transverse or oblique presentations.

• foetal heart is best audible through its left scapular region in vertex and breech presentation and face presentation, the heart sounds are heard through the foetal chest.

• Depending on the position of fetal back towards left or right side, fetal heart sounds would be heard on same  side. It is nearest midline in anterior positions and further away from midline in posterior positions.

For example

1. left occipito-anterior position  (FHS is located middle spino-umbilical line left side)
2. right occipito-anterior position ( FHS is located middle spino-umbilical line right side)
3. occipito-lateral position ( it is heard more laterally )
4. left occipito-posterior position ( it is heard more posteriorly on the maternal flank on left side.)
5. occipito-posterior positions ( it is heard more posteriorly,  well back towards mother flank on the same side)

Question (AIIMS Bhopal Nursing officer, 2018)

• In left occiput anterior fetal position, the fetus heart sound is located at:

1.  Around the umbilicus
2.  Back towards the mother's flank of the same side
3.  Middle of the spino-umbilical line of the same side
4.  Below the umbilicus

• Right answers - (3) Middle of the spino-umbilical line of the same side

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Nursing Officer

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