Accuracy, Clinical Utility, and Usability of a Wireless Self-Guided Fetal Heart Rate Monitor

Paul Porter, Fleur Muirhead, Joanna Brisbane, Brooke Schneider, Jennifer Choveaux, Natasha Bear, Jennie Carson, Kym Jones, Desiree Silva, Cliff Neppe

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objective: To evaluate the accuracy, clinical utility, and usability of a wireless fetal and maternal heartbeat monitor to monitor fetal heart rate (FHR).

Methods: We conducted a prospective, single-center study of a convenience sample of women aged 18 years or older with a singleton pregnancy of at least 12 weeks of gestation. Fetal heart rate recordings were performed using both the heartbeat monitor and cardiotocography to evaluate accuracy. Clinicians used the heartbeat monitor in the clinic. Women used the device, unassisted, during a clinic visit or at home. Obstetricians assessed the clinical utility of FHR traces. Women rated the heartbeat monitor using the System Usability Scale.

Results: A total of 81 participants provided 126 recordings. The accuracy of the heartbeat monitor was excellent compared with cardiotocography, with limits of agreement (95%) for mean FHR between -1.6 (CI -2.0 to 1.3) and +1.0 (CI 0.7-1.4) beats per minute (bpm), mean difference -0.3 bpm, intraclass coefficient 0.99. The FHR was detected on all occasions. Clinicians took a median (interquartile range) of 0.5 (0.2-1.2) minutes to detect the FHR, obtaining a continuous trace of longer than 1 minute in 95% (39/41) of occasions. Home users took a median of 0.5 (0.2-2.0) minutes to detect the FHR, obtaining a continuous trace of longer than 1 minute in 92% (24/26) of occasions, with a median total trace time of 4.6 (4.4-4.8) minutes. The traces were deemed clinically useful in 100% (55/55) of clinician and 97% (31/32) of home recordings. The heartbeat monitor ranked in the 96-100th percentile for usability and learnability.

Conclusion: The heartbeat monitor was accurate and easy for clinicians and participants to use. Data recorded at home were equivalent to those obtained using current assessment protocols for low-risk pregnancies, potentially allowing the device to be used in telehealth consultations.
Original languageEnglish
Pages (from-to)673-681
JournalObstetrics & Gynecology:
Volume137
Issue number4
DOIs
Publication statusPublished - 1 Apr 2021

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