Listening and monitoring fetal heart rate
In a labour room, the process of childbirth is emotional and vulnerable for the mother. Staff nurses in the labour room are usually occupied and pressurized under the circumstances of each individual mother, to deliver healthy babies and maintain good health of the mother. Monitoring the mother and the baby (fetus) during Labour/the child birth is essential to ensure best outcomes for both. At Haridwar, Chain Rai Women’s Hospital Vriddhi project introduced standardized fetal heart rate (FHR) hand held doppler designed by Laerdal, called Moyo.
The monitoring device, Moyo, helps the staff nurse in the labour room to monitor faster, easier and effective FHR and raises alarm if abnormal FHR is recorded. The calculated fetal heart rate is presented on the display together with an audible (doppler) sound. It can be used handheld or strapped on to the mother for prolonged monitoring. Moyo has an alarm function and a 30-min histogram. Improving quality in FHR monitoring practices, has led to more frequent and timely obstetric responses.
Staff nurse Poonam at the Chain Rai Women’s Hospital, with an experience of over five years in the labour room has been working with the Moyo device since August 2019. She says, “The fetal heart rate monitor is a good device, which is easy to use and helps get accurate heart rate of the fetal (baby). Earlier we used stethoscope to check the fetal heart rate, which is a time consuming process as it took time to find the heart beat and multiple times we would have to repeat the process in order to keep records. Now we only use Moyo, strep it to the mother’s belly with a flexible band attached with the monitor, when the mother is at the second stage of labour. As the Moyo is light weight, it helps mothers to move around. We then explain the mother about the device and assures her of the baby’s vitals. the beeping sound in the monitor indicating the fetal’s heart rate. In case there are some irregularity in the FHR, the monitor raises alarm, alerting the mother and staff nurses. With the device being part of our system, it has become easy for us to monitor the FHR and at same time, give time to other required procedure to prepare for the delivery.”
Ratna, a first time mother aged 22 years experiencing second stage labour was asked to wear the Moyo device, by strapping the device on her belly with help of flexible band to tie around the belly. The mother shared her experience, “initially I was scared and confused with the device that the sister strapped around me. After the sister Poonam explained me the work of the Moyo device, I was able to understand the beeping sound of the baby.” This device is helping build better relations between the mother and baby during the child birth process, and also helps in cooperating the staff nurse.
In India, there are 1.02 million fresh stillbirths (FSB) occur, and intrapartum-related neonatal deaths account for almost 40% of 2.6 million neonatal deaths, annually. With the introduction of Moyo in labour rooms, it saves time and timely detect fetuses at risk can help prevent many of the early stillborn and asphyxia deaths. Under the Laqshya initiatve of MoHFW, MOYO is being implemented through USAID-VRIDDHI project implemented by IPE Global. The team aims to reduce the mortality rate, by introducing Moyo at 3 levels of public health facilities (CHC FRU, District Hospital and Government Medical College) across the states of Jharkhand, Odisha and Uttarakhand.