Moyo Doppler versus pinard fetal scope: midwives’ experience on fetal heart rate monitoring during labor at Muhimbili National Hospital, Tanzania.

Abstract

Background: Fetal heart monitoring using Pinard fetoscope is the common midwifery experience. However Moyo Doppler has been currently introduced at Muhimbili National hospital (MNH) to replace the former device, since fetal heart monitoring during labor is a vital experience , poor fetal heart rate monitoring during labor is directly associated with over 40% of perinatal deaths. Since the new device was introduced, midwives' experiences on using the device are not well known. Aim: To explore midwives’ experience on utilization, preference and challenges, between Moyo Doppler and Pinard fetoscope on fetal heart rate monitoring during labor. Method: This was a descriptive equalitative study which involved in-depth interviews. The Eight (8) in in-depth interviews were conducted with midwives in order to explore their experience on using Moyo and Pinard fetoscope on fetal heart rate monitoring during labor at MNH. The participants for in - depth interviews were registered midwives, and these participants were selected purposively. All interviewees were audio recorded with participants’ consents. Data from the in–depth interviews were analyzed using the qualitative content analysis, meaning units from the interview scripts were summarized into condensed meaning units and then coded. The codes were compared based on similarities and differences then sorted into categories; the underling meaning of categories were linked together to create a theme emerged in order to describe midwives experience. Ethical: The ethical clearance was obtained from MUHAS at the Directorate of Research and Publications prior to conducting the study and the permission to conduct the study was sort from Muhimbili National Hospital Authority. Participation was voluntary. Findings: The findings from this study revealed that the participants preferred to use Moyo Doppler than Pinard fetoscope because the Moyo Doppler simplifies work and keeps records of FHR and MPR for 30 minutes, and it also helps the midwives to monitor multiple laboring woman at the same time and it has audible sound which al about the danger sign for immediate intervention. However it reduces the chance of contamination due to its application. Moreover in this study some challenges facing midwives on using Moyo Doppler over Pinard fetoscope were reported. There was power cut off and insufficient of Moyo device in labor ward. It was reported that Pinard fetoscope is difficult to use especially for midwives who have problem in hearing, and problem to allocate the back of the fetus especially to the obese and woman with edema also backache due to frequent bending when listening the fetal heart rate. Pinard fetoscope cannot differentiate the FHR and MPR at the same time; it is a task of a midwife to differentiate them. Conclusion The study has reveled that most midwives had experience on Moyo Doppler for fetal heart rate monitoring. Most midwives preferred to use Moyo Doppler due to its easier usability, it reduces the work load, produces reliable results and it detects fetal abnormalities early and helps midwives to take action immediately.Furthermore midwives explained that utilization of Pinard fetoscope should not be abandoned. Recommendation • Pinard fetoscope should not be abandoned because in case of electricity cut off Pinard fetoscope can be used. • On-job training on using Moyo Doppler may be conducted to all all midwives who are working at maternity block. • Muhimbili National Hospital authority may advise the government to ensure that Moyo Doppler can be used in regional and district hospitals because it helps to reduce the work load of the midwives. • Policy maker may advise to include Moyo Doppler in the midwives training curriculum as Pinard fetoscope. • Further research may be carried out to all hospital using Moyo Doppler to explore and determine the midwives’ experience on using the Moyo Doppler device by using both method qualitative and quantitative approach. ert the midwives