![]() FHR and movement data are combined to estimate fetal hypoxia at the time of the test, reported as reactive or non-reactive (definitions and assessment criteria: Box 1), which is used to judge fetal health and guide clinical interventions. In high-risk pregnancies and emergencies, a Non-Stress Test examination (NST) is performed using cardiotocography (CTG) to collect comprehensive FHR data (fetal cardiography) for >10 minutes and to assess uterine contractions (tocography) 2. This process is known as intermittent auscultation (IA) 1. During routine low-risk antenatal consultations, the fetal heart rate is measured briefly by a handheld doppler device, a DeLee-Hillis stethoscope, or a Pinard horn, depending on available skills and resources. The fetal heart rate (FHR) and heart rate variability are used as indicators of fetal wellbeing in utero. It is usable by expectant mothers with minimal training. ![]() The HBM is as accurate as gold-standard CTG, and provides equivalent clinical information enabling use in non-stress test analyses conducted outside of hospitals. The monitor ranked in the 96–100 th percentile for usability and learnability. They achieved the required length of recording required for non-stress test analysis. Thirty-four (100%) women successfully detected the FHR and obtained clinically useful cardiographic data using the device at home unsupervised. Both methods were equally interpretable by Obstetricians, and had similar signal loss ratios. The FHR was detected on all occasions and confirmed to be different from the maternal heart rate. The accuracy of the HBM was excellent, with limits of agreement (95%) for mean fetal heart rate (FHR) between 0.72 and −1.78 beats per minute. Sixty-three women had paired clinic-based HBM and CTG recordings, providing 6982 fetal heart rate measures for point-to-point comparison from 126 min of continuous recording. Women then used the HBM unsupervised and rated the experience. Initially, participants had paired HBM and CTG examinations performed in the clinic. We compared the accuracy, clinical interpretability, and user experience of a patient-administered, wireless, fetal heartbeat monitor (HBM) designed for home use, to CTG. New technologies may permit home-based, self-administered examinations. Fetal Cardiography is usually performed using in-hospital Cardiotocographic (CTG) devices to assess fetal wellbeing.
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