Evaluation of a wireless fetal heart rate monitor demonstrates high agreement with heart rate, as assessed by cardiotocography, and is feasible for use at home.

ObjectiveTo evaluate the accuracy, reliability, clinical utility, and usability of HeraBEAT, a wireless fetal and maternal heart rate monitor (HBM) when used by clinicians and pregnant women to monitor fetal heart rate (FHR).MethodsWe recruited women aged 18 years or older with a singleton pregnancy of ≥12 weeks gestation. FHR recordings were performed using the HBM and cardiotocography (CTG) to determine comparative accuracy. The HBM was then used by clinicians and participants in the antenatal clinic with the latter then using the device unassisted to record at home. The women rated the HBM using the System Usability Scale (SUS).ResultsA total of 81 participants provided 126 recordings for analysis. The accuracy of the HBM was excellent compared with CTG, with limits of agreement (95%) between −1.5 and +0.9 beats per minute (bpm) and a mean difference of −0.29 bpm. The FHR was detected on 100% of occasions by clinicians (52 recordings) and participants when used in the clinic (42 recordings) and at home (32 recordings). Home users took an average of 1.1 minutes to detect the FHR and recorded a continuous trace of >1 minute in 94% of occasions, with an average total trace time of 4.4 minutes. The FHR trace was deemed to be clinically useful in 100% of clinician recordings and 97% of home recordings. There was no effect from body mass index, gestational age, pregnancy history, or placental position. The HBM ranked in the 96–100th percentile on the SUS for usability and learnability.ConclusionsThe HBM was accurate and easy for clinicians and participants to use. The data recorded at home was equivalent to that obtained in the clinic using current assessment protocols for low-risk pregnancies, allowing the device to be used in telehealth consultations.Clinical Trial RegistrationAustralian New Zealand Clinical Trial Registry, https://www.anzctr.org.au ACTRN12620000739910.

Over 80 % of ovarian cancer diagnoses are in women aged over 50 years. Post-menopausal women are at significantly increased risk compared with other age groups. Tumour biomarkers and ultrasound assist with diagnostics. A post-menopausal woman was referred with a possible left adnexal cyst on ultrasound. A tertiary gynaecological ultrasound suggested bilateral hydrosalpinges without cysts. Tumour markers were negative. Unexpectedly, while undergoing a laparoscopy, the tubes were normal in appearance; however, multiple cystic deposits suspicious for malignancy were noted on the ovaries. A laparoscopic bilateral salpingo-oophorectomy was performed without spillage and pelvic washings obtained. On histopathology, the ovaries contained multiple, benign epithelial cysts and pelvic washings were negative. This case demonstrates an unanticipated peri-operative diagnostic dilemma. It highlights the surgical management decisions required to balance duty of care and consent compliance within the scope of general gynaecology. It emphasizes the importance of histopathological examination to confirm diagnoses.