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Robyn Maude PhD, MA (Applied) Midwifery, BN, RM, RN

Senior Lecturer, Director Student Research

Graduate School of Nursing, Midwifery and Health - Te Kura Tapuhi Hauora

Victoria University of Wellington. New Zealand

Intelligent Structured Intermittent Auscultation (ISIA): fetal heart monitoring for low risk women


The fetal heart rate (FHR) monitoring framework Intelligent Structured Intermittent Auscultation (ISIA) was developed as a tool to support midwives’ evidence-based practice for admission assessment and monitoring during labour for low risk women in any birth setting. The ISIA framework is a collection of clinical skills and indicators, that includes listening to the fetal heart, to facilitate informed decision making, choice of fetal heart monitoring modality, and critical thinking around the actions arising from assessments and examinations. Although intermittent auscultation (IA) has been around a long time, ISIA is in effect asking something new of practitioners in relation to auscultation of the fetal heart. Intrapartum fetal monitoring using the ISIA framework provides a comprehensive method with which to monitor fetal wellbeing at the start of active labour and throughout for low risk women. The purpose of this presentation is to describe the application of the ISIA decision-making framework in practice.