Quillen College of Medicine, East Tennessee State University


   Fetal heart sounds were reportedly first detected by Marsac in the 1600’s. The idea that fetal heart rate could be used to determine fetal well being was first proposed by Killian in the 1600’s. This idea went unnoticed until 1818 when Mayor and Kergaradec described the method of  auscultating fetal heart sounds by placing the ear next to the maternal abdomen. Kergaradec further suggested that fetal heart sounds could be used to determine fetal viability and life. By 1833, Evory Kennedy, an English physician, published guidelines for fetal distress and recommended auscultation of the fetal heart rate as a tool of intrapartum monitoring. In 1893, Von Winkel established criteria for fetal distress that remained unchanged until the advent of electronic fetal monitoring (tachycardia – FHR>160, bradycardia – FHR < 100, irregular heart rate, passage of meconium, and gross alteration of fetal movement). By the turn of the 20th century, various authors had described fever as a cause of fetal tachycardia, head compression and cord compression as a cause of bradycardia, and hyperstimulated uterine activity associated with a characteristic fetal heart rate response and asphyxia.

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