Doppler ultrasound technology for fetal heart rate monitoring: a review

Paul Hamelmann (Corresponding author), Rik Vullings, Alexander F. Kolen, Jan W.M. Bergmans, Judith O.E.H. van Laar, Piero Tortoli, Massimo Mischi

Research output: Contribution to journalReview articleAcademicpeer-review

11 Citations (Scopus)
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Fetal well-being is commonly assessed by monitoring the fetal heart rate (fHR). In clinical practice, the de facto standard technology for fHR monitoring is based on the Doppler ultrasound (US). Continuous monitoring of the fHR before and during labor is performed using a US transducer fixed on the maternal abdomen. The continuous fHR monitoring, together with simultaneous monitoring of the uterine activity, is referred to as cardiotocography (CTG). In contrast, for intermittent measurements of the fHR, a handheld Doppler US transducer is typically used. In this article, the technology of Doppler US for continuous fHR monitoring and intermittent fHR measurements is described, with emphasis on fHR monitoring for CTG. Special attention is dedicated to the measurement environment, which includes the clinical setting in which fHR monitoring is commonly performed. In addition, to understand the signal content of acquired Doppler US signals, the anatomy and physiology of the fetal heart and the surrounding maternal abdomen are described. The challenges encountered in these measurements have led to different technological strategies, which are presented and critically discussed, with a focus on the US transducer geometry, Doppler signal processing, and fHR extraction methods.

Original languageEnglish
Article number8848855
Pages (from-to)226-238
Number of pages13
JournalIEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Issue number2
Publication statusPublished - Feb 2020


  • Cardiotocography (CTG)
  • Doppler ultrasound (US)
  • fetal heart rate (fHR)
  • fetal monitoring


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