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VOL. 8, ISSUE 2 (2026)
Advanced Intermittent Auscultation (AIA) of fetal heart rate in labour - A comprehensive regime & training module for international midwifery / obstetric practice
Authors
Shashikant L Sholapurkar
Abstract
Judicious intrapartum fetal heart rate (FHR) monitoring is important to prevent birth asphyxia. In many developed countries ‘intermittent auscultation of FHR (IA)’ is an accepted method in low-risk labours. Furthermore, cardiotocography (CTG) is not available widely in resource-poor countries where IA is the only choice. It has been traditional to actually count the fetal heart tones during IA and most international guidelines still insist on that. However, hand-held Doppler FHR monitors are now affordable and widely available all over the world. Because the Doppler monitors display an accurate concurrent FHR, there seems no need to actually count anymore. A recent survey of British midwives revealed that 65% found counting FHR every 5 minutes in second stage very laborious and 76% said they sometimes simply couldn’t adhere to this frequency. ‘Advanced Intermittent Auscultation’ does not require manual counting and relies on visual (and audible) interpretation of displayed FHR on the Doppler device after uterine contractions. AIA has been proposed to be more scientific, less laborious, more versatile and safer than the other regimes of IA. This article makes ‘AIA regime and training module’ accessible in a published form for use by birth attendants in different parts of the world.
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Pages:15-24
How to cite this article:
Shashikant L Sholapurkar "Advanced Intermittent Auscultation (AIA) of fetal heart rate in labour - A comprehensive regime & training module for international midwifery / obstetric practice". International Journal of Gynaecology and Obstetrics Research, Vol 8, Issue 2, 2026, Pages 15-24
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