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How to fetal heart auscultation sounds

into the beginning of obstetrics and gynecology practice, the steps to listen to fetal heart sound is like?
How to find the location of fetal heart rate?
Relatively clear how the fetal heart heard?
Hereby sorted out and shared with them.
(A) of the fetal heart tone auscultation Operation 1. To bring to the bedside with the property 2. Verifying a patient 3. Wash your hands 4. To explain the purpose of their patients to guide the patient 5. Occlusion patients 6. To help put position (supine, lateral, semi-
supine, legs straight) 7. exposure to the abdomen 8. to determine the location of the back tire 9. coated with coupling agent in 10 pregnant women on the abdominal skin. the auscultation probe (receiver) on the child back at auscultation 11. hear the clocks "tick
"Two tone, count 1 minute 12. Note that the frequency of fetal heart rate, rhythm, strength 13. attention to tone the abdominal aorta, uterus noise, phase noise identification of umbilical cord 14. inform the fetal heart sound normal range and the test results 15
. wiped the abdomen and the probe coupling agent 16. to help women dress and restore comfortable position 17. inform the pregnant woman the importance of self-monitoring of fetal movement, the church self-monitoring of pregnant women, fetal movement method 18. recorded fetal heart rate fetal heart rate values ​​and the time to listen to 19.
hand (b) the guidance of pregnant women know about fetal heart sound common sense 1.
Inform pregnant women 18 to 20 weeks of gestation, the abdominal wall with a stethoscope or the handset can hear the fetal heart sound, normal 120 to 160 times / min.
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Inform pregnant women at 18 to 20 weeks pregnant fetal movement perceived, the normal 3 ~ 5 times / h.
(C) Note 1.
Indoor environment to be quiet and active support of pregnant women.
Listen to fetal heart tones, the noise with the uterus, abdominal aorta and the umbilical cord noise differentiated sound.
If the fetal heart sound <120 beats / min or> 160 beats / min, immediately compare the pulse palpation of pregnant women to identify, if necessary, oxygen, left lateral position, the fetal heart rate monitoring.
(D) the relevant knowledge 1.
Fetal heart tones and other noise in the identification of: ① fetal heart tones: fetal heart tones were two-tone, like the ticking of clocks.
Slightly faster.
② uterine noise: In order to increase blood flow through the uterine blood vessels that occurs when the soft, hair-like, low sound.
③ tone the abdominal aorta: the monotonous tone and strong pound, pregnant women, like the pulse of the same.
④ noise umbilical cord: cord blood flow is blocked appears consistent with the fetal heart sounds like the low sound hair, changes in position may disappear.
The role of fetal heart rate monitoring: a continuous record of fetal heart rate can change, but can also observe fetal movement, uterine contractions on fetal heart rate.
It has two functions, monitoring and prediction of intrauterine fetal heart rate reserve capacity.
Where fetal movement and fetal heart rate abnormalities or high-risk pregnancy and labor in late pregnancy should be done after the fetal heart rate monitoring.
Auscultation fetal heart tones site: pregnancy before 24 weeks, fetal heart sound more in the middle or slightly below the belly button left or right to hear; fetal heart tones after 24 weeks of pregnancy, more than most clearly heard in the fetal dorsal.
Method of self-monitoring of fetal movement: Well pregnant women a day early, middle and late fetal movement several one-hour, 3 times 4 times the sum of the number of fetal movement was 12h.
If fetal movement less than 3 times per hour, 12h fetal movement less than 10 times, or more than 50% over the previous fall, and those who can not be restored, suggesting that fetal hypoxia.
Oh, for the fetal heart tones have a comprehensive understanding of the bar.
If you have anything to add, welcome guidance.