Fetal Heart Tone Assessment

Obtain patient's history to determine the presence of conditions that may complicate the delivery or resuscitation of the neonate.

  1. Perform hand hygiene and apply gloves.
  2. Verify patient's identity in accordance with institutional policy.
  3. Place the patient in the supine position.
  4. Palpate to find the fetal position. Palpate the back of the fetus, which feels like a flat surface, and place the Doppler probe on the abdomen where the flat surface is palpated. The FHTs are usually located in the mother's right or left lower abdominal quadrant.
  5. Place the conductive gel on the abdomen or on the Doppler probe.
  6. Locate the heartbeat and listen at the point of maximal intensity.
  7. Count the FHR for 30 to 60 seconds between contractions (if present) to obtain a baseline rate. The maternal pulse should be monitored simultaneously when the FHR is assessed. Normal FHTs range between 120 and 160 beats/min.
  8. If the FHTs cannot be heard, reassure the mother that there are many possible reasons for this, and request assistance from an obstetric nurse or obstetrician.
  9. Check the FHTs each time the mother's vital signs are checked. If the mother is in labor, FHTs should be checked at least every 15 minutes in early labor and every 5 minutes in second-stage labor.
  10. Discard supplies, remove gloves, and perform hand hygiene.
  11. Document the procedure in the patient's record.