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One size fits all? Fetal monitoring options to address diverse patient care needs

Photo: One size fits all?
Moms come in all shapes and sizes. They also come with different fears and anxieties, diverse cultures and experiences, and co-morbidities and risks. All these factors determine the type and level of care needed. Practices have been adjusted and services added to accommodate these needs – birthing suites designed with the latest technology and with the comforts of home in mind, labouring tools including birthing balls and baths, and flexible choices in pain reduction.  However, similar solutions in fetal monitoring seem to be a much more contentious effort. Is fetal monitoring a one size fits all solution?

Perhaps one of the reasons fetal monitoring hasn’t reached the ’a-la-cart menu’ is because today’s technology offers few options. For high-risk patients, continuous electronic fetal monitoring is most commonly recommended, however due to physiological and technological challenges clinicians have limited options to effectively monitor these patients – particularly high BMI patients.
Electronic fetal monitoring on high BMI moms today most commonly occurs with cardiotocography (CTG) using doppler ultrasound or with internal electrocardiography via fetal scale electrodes. Both technologies have their limitations clinically and often subject patients to positioning and prodding that can be uncomfortable and undignified.

Exciting technology has emerged in fetal monitoring using external wireless fetal electrocardiography (fECG).  A GE Healthcare solution called the Monica Novii Wireless Patch System, developed in the United Kingdom, is receiving rapid adoption. This intrapartum maternal/fetal monitor non-invasively measures and displays fetal heart rate (FHR) as well as maternal heart rate (MHR) and uterine activity (UA). Novii acquires and displays the FHR tracing from abdominal surface electrodes (Novii Patch) that pick up the fECG signal.  With this same surface electrode system, Novii acquires and displays the UA tracing from the uterine electromyography (EMG) signal and the MHR tracing from the maternal ECG signal (mECG).

Novii monitors the electrical signals on the patient’s abdomen. Research shows that these signals are not compromised by high BMI and can offer an effective and accurate solution to monitor high-risk patients. Novii may open the doors to a much more flexible and comfortable experience for patients. Since acquired data is sent via Bluetooth to the monitoring interface, there’s no need for cords from the patient to the monitor. In addition, the electrodes secure to the patient’s abdomen via the wireless patch system, so there’s no need for belts around the patient’s abdomen to secure transducers and no need to reposition once a signal is acquired. Novii can even be used in the shower and during an epidural placement.

Patients are all different and need care options to meet their needs – this may not point to a one-size fits all solution, but rather to the need for flexible care options. New technology can introduce alternate options for patients and midwives while maintaining data accuracy and improving outcomes.

To learn more about the Novii Wireless Patch System contact Deb Mayor Deborah.mayor@ge.com

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