The procedure for using a pinard stethoscope is quite different
to using a fetal Doppler, however the midwife will still need to discuss the
procedure with the woman and gain her informed consent, as well as that an
abdominal palpitation is still needed to be performed before the procedure is carried
out. It is recommended that before the midwife auscultates the fetal heart
using the Doppler, that the midwife uses the pinard stethoscope to auscultate
the fetal heart. RCM (2012) state ” A pinard or fetal
stethoscope should be used at initial assessment to establish the real sound of
the fetal heart and to aid confirmation of presentation and position”. https://www.rcm.org.uk/sites/default/files/Intermittent%20Auscultation%20(IA)_0.pdf.
Once the pinard stethoscope has been used, the midwife must then
use a suitable conductive gel in order to lubricate the Doppler ultrasound. The
Doppler needs to be lubricated because as the ultrasound uses sound waves, the sound
waves do not travel well through air, therefore any trapped air between the probe
and the skin would cause a problem and disturb any sounds that the Doppler would
pick up (http://www.two-views.com/ultrasounds/gel-goo.html#sthash.fe1HR69K.dpbs).
After the Doppler ultrasound had been lubricated, the midwife would position the
Doppler probe over the area where she heard the fetal heart using the pinard stethoscope.
The midwife would then count the fetal heart beat for one minute whilst also palpating
the maternal radial pulse to ensure that it is the fetal heart beat that is being
heard. The midwife would then also reassure the woman about the other sounds that
can be picked up by the Doppler ultrasound, for example the placenta and maternal
pulse can be heard by the Doppler ultrasound as well. Then as expected, the midwife
would wipe the gel off the Doppler with a tissue and discuss the results with the
woman then document the findings and act accordingly (R Johnson, W Taylor Skills for
Midwifery Practise 4th edition 2017, edn. Edinburgh: Elsevier). 

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