The AIUM released a Statement on Measurement of Fetal Heart Rate last month which can be found on their website, www.aium.org/publications/statements.aspx. As a result, because our ultrasound practice is accreditated by the AIUM, we changed our policy and only document the fetal heart rate by M-mode. I have had only a few instances where the M-mode was not successful due to maternal morbid obesity but in the majority of cases M-mode is sufficient. Due to the nature of our patients in a high-risk setting, many are anxious to hear the heart beat as well. In those cases, the staff can use a hand-held Doppler to allow for the audio to supplement the visual confirmation of cardiac activity. On rare occasions, we have let the patient hear the heart beat for three or four beats (making sure the TI is appropriate). Honestly, I thought we would get a lot more negative feedback than we have. We have had to answer some questions as to the change in protocol and some patients have asked if we don't use the Doppler at all then is ultrasoound safe. This is a modification that is in the best interest of our patients and their babies. I encourage you all to make this change in ultrasound practice but be prepared to answer questions.