Handheld Doppler Versus Pinard Stethoscope for Intrapartum Foetal Monitoring at A Tertiary Centre in Nigeria: A Randomised Controlled Trial

Abstract

Background: Stillbirth is a major contributor to perinatal mortality rate, majority of which occur intrapartum. Intermittent auscultation is the method of choice in low risk pregnant women and mostly available in the West African sub-Saharan region. General objective: This study aimed at comparing the use of Pinard stethoscope and hand held Doppler in foetal monitoring during labour. Methods: The study was carried out in the labour ward of the Federal Medical Centre Katsina. It consisted of 220 low risk pregnant women randomized to either hand held Doppler or intermittent auscultation with Pinard Stethoscope for foetal monitoring in labour. The outcome measures were studied. Significant p values were set at <0.05. Data was analysed using SPSS version 20.0. Results: There were no statistically significant difference between the two groups in the socio demographic characteristics, obstetric characteristics, rate of abnormal foetal heart rate detection (Fisher’s exact test, p = 0.667), mode of delivery, (X² = 0.096, p = 0.953), foetal birth weight (X² = 3.12, p = 0.128), admission into the neonatal special care baby unit (X² = 1.019, p = 0.622) and APGAR score at 5minutes (X² = 0.338, p = 1.000). There was higher level of maternal satisfaction in the Hand held doppler group, Likert scale (X² = 24.029, p = < 0.001) and Ordinal logistic regression. Conclusion: Hand held doppler is comparable to Pinard stethoscope in terms of foetal heart rate abnormality detection, foetal and maternal outcomes with higher maternal satisfaction in the Hand held doppler group.