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Comparing Methods to Secure External Fetal-Monitoring Devices

Panelli, Danielle BS; Teplick, Frann MSN, RN-BC, CNS; McCarthy, Mieka BSN, RN; Hebert, Stephen MD, FAACOG

MCN, American Journal of Maternal Child Nursing: January/February 2014 - Volume 39 - Issue 1 - p 41–47
doi: 10.1097/NMC.0b013e3182a8de72
Feature: CE Connection

Purpose: To compare two methods of securing external uterine tocodynamometer and fetal heart rate (FHR) ultrasound monitors to the abdomen.

Study Design and Methods: 100 women were enrolled in a prospective, randomized trial comparing the adhesive patch method to the circumferential belt method for securing electronic fetal monitoring (EFM) devices during labor. Device efficacies were compared by evaluating the EFM time lost due to monitor malpositioning. Investigator-developed nurse and patient questionnaires were used to assess satisfaction with each device.

Results: Data from 94 patients and 21 nurses were analyzed. There was no significant difference in efficacy between the two devices. There was a significant preference for the adhesive patch method in the nurses' assessment of EFM positioning, continuous assessment during epidural, and assessment during labor and birth, and in the patients' assessment of their mobility and comfort. This suggests that the adhesive patch method is equivalent to the circumferential method in its primary purpose (its ability to effectively position the EFM devices) and preferable over the circumferential method in terms of nurse and patient satisfaction.

Clinical Implications: The adhesive patch method of securing fetal-monitoring devices could be welcomed as a suitable alternate to the circumferential belt method during labor.

Women complain about the belts for fetal monitoring. Nurses complain about the belts as well. Is there a better way?

Danielle Panelli is a Medical Student, UC San Diego School of Medicine, San Diego, CA.

Frann Teplick is a Perinatal Clinical Nurse Specialist, UC San Diego Health System, San Diego, CA. As the corresponding author, Ms. Teplick can be reached at

Mieka McCarthy is a Staff Nurse, L&D, UC San Diego Health System, San Diego, CA.

Stephen Hebert is a Clinical Professor, UC San Diego Health System, San Diego, CA.

For more than 80 additional continuing nursing education activities on neonatal topics, go to

The authors have declared no conflict of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.