GENERAL
ULTRASONIC "FOETAL MONITOR" is an acoustic instrument, utilizing reflected low intensity ultrasonic vibrations, which are tone (frequency) modulated according to the Doppler principle.

The transducer directs a continuous ultrasonic beam into the body. The beam is reflected from the interfaces at the same frequencies until a moving interface is encountered. When the received frequency is compared with that from transmitter, the difference between the two becomes the audible sound signal at the same rate as the moving interface. Thus any movement in the path of ultrasonic beam causes a frequency change due to the Doppler principle, in the returning echo.

TECHNICAL DATA
» Ultrasound System
2.25 MHz, Operating Frequency.

» Controls
Independent volume control.

» Power Supply Batteries
Six 1.5 V (1050 Eveready or equivalent) batteries.

» Mains
220 V 1 , 50 Hz AC

» Battery Indicator
LED indicator flashes to indicate discharged batteries.

» Transducer
Ultrasound sensors with 1.5 m long cable and plug.

» Earphone
By connecting the earphone the built-in loudspeaker switches off automatically.

» Tape Recording
Socket for small recording plug.

» Dimensions
225 mm x 1600 mm x 100 mm
§ Weight
Approximate 2 Kg

CONTROLS
» Supply Switch
A Rocker switch is provided on the front panel, which can be kept in up or down position. In the down position indicated by MAINS, make the instrument ON in AC mode. In up position indicated by BATTERY, make the instrument ON in Battery mode. The center position of the switch is OFF.

» Volume Control
A knob on the front panel indicated by 'VOLUME' is used to control the sound level. Turning it in the clockwise direction the sound level increases and in the anti-clockwise direction the sound level decreases.

» Battery Condition Indicator
A red LED indicated, as 'BATT' will glow on switching ON the instrument. If it starts flickering, it indicates that the batteries are run down, and should be replaced.

» Transducer Socket
A three-pin socket on the front panel indicated by 'PROBE' is the coupling for the transducer to the instrument.

» Stethoscope
A socket is on the left side of the instrument. On inserting stethoscope plug inside the ear socket the loudspeaker is cut off and now you can hear through the stethoscope.

» Tape Recording
A socket is on the left side of the instrument. Connecting the FMII through a proper cord to the auxiliary input of any standard tape recorder you can record the sound output for further studies.

» Supply
230 Volts AC, 50Hz

OPERATION AT A GLANCE
1. Open the pouch and take out oil bottle and transducer.
2. Keep the instrument firmly on the table, near the patient and within your operating reach.
3. Insert the three-pin transducer connector in the socket, taking care of proper direction.
4. Turn the volume control knob in the anti-clockwise end position.
5. Switch on the instrument with the flip of your finger to put it in the lower ON position. The red LED indicator should glow without flicker. If it starts flickering, it indicates that the batteries are run down, and should be replaced.
6. Apply olive oil / ultrasonic jelly on the area of inspection and spread it with cotton to form a thin layer. Hold the transducer firmly in place with moderate pressure.
7. Adjust the volume control to its center position turning it clockwise.
8. Now tilt the probe slightly in various directions without loosing contact with the skin, until the pulse is heard. If no pulse is heard the transducer is moved a few centimeters and the procedure be repeated.
9. Once the proper position is located, adjust the volume control to the required sound level for clear sound output.
10. If the examination place happens to be of high surrounding noise level or in case you do not want the patient to hear the pulse output, the stethoscope type earphone can be used. Before switching on the instrument, insert the earphone pin in the socket marked EAR on the left side of the instrument. The built-in loudspeaker gets automatically cut off and now you can hear through the stethoscope.

REPLACEMENT OF BATTERIES
Open the carrying case front flap and pull out the instrument.

Keep the instrument on the table upside down and remove the two big screws on the bottom / back cover. Remove the bottom cover plate. Now you can see six 1.5 volts batteries placed in two rows.

First remove the two center batteries and then slide one by one the other four batteries. Now insert the new batteries taking care of the polarity direction as shown on the battery box.

Replace the cover with two screws and put the instrument back in the carrying case.

Switch on the instrument and check that the battery indicator LED does not flicker.

PRECAUTIONS
1. Operate the instrument on 230 volts, 50Hz, single phase AC supply.
2. The metallic casing of the transducer encloses brittle crystals, hence dropping it from a great height or rough handling may damage it.
3. Place the instrument near the patient so that the transducer cable is not stretched fully to avoid tension on the terminals.
4. DO NOT sterilize any part or accessory of the instrument, to avoid permanent damage.
5. DO NOT allow the oil to enter through cable entry point of the transducer. Always keep the transducer clean. Oil may be wiped out with a clean cloth or cotton.
6. Avoid contact of solvent Ether with the transducer.
7. DO NOT keep the instrument in direct sunlight for a long period.
8. If the instrument is not in use for one month or more, remove the batteries and store it in cool, dry place.
9. Close the instrument after ensuring that it is switched off.
10. The three-pin connector of the transducer should be inserted properly to avoid disturbance in sound output.

ULTRASONIC DOPPLER TONE APPLICATIONS
Some to the typical applications in obstetrics and gynecology fields are explained in more details.

» Obstetrical Applications
High frequency ultrasound wave is highly attenuated in the air medium. However, an ultrasound passes easily through water and most liquids. To avoid high attenuation of ultrasound in air medium and for maximum refraction of ultrasound wave in the body, the area of inspection is coated with olive oil. This problem may occur during early pregnancy up to about 16 weeks, when portion of gut lies between the uterus and the abdominal wall. It is advisable for a patient to have full bladder. This helps to raise the fundus and also provides an easy path for the ultrasound wave.

» Detection of Maternal Heart Beats
Apply oil and place the probe upon the normal heart location; the sound of maternal heart movements can be clearly heard on the loudspeaker. The maternal heart beats rate helps to confirm the further diagnosis of foetal heart and placenta.

» Early Pregnancy Detection
Apply olive oil or ultrasonic jelly on the medial line just above the Symphysis Pubis, and spread it with cotton to form a thin layer. Hold the transducer firmly in place with moderate pressure, and tilt the probe slightly in various directions without loosing contact with the skin, until the foetal heart pulse is heard. If no foetal pulse is heard, the transducer is moved a few centimeters higher and the procedure is repeated. As the uterine arteries will at times be heart, confusion between these and the foetal pulse can be avoided if the patient's pulse is felt at intervals during the examination.

» Later Pregnancy Detection
To determine the foetal heart precisely, the area of examination is scanned carefully by placing the transducer at various positions on the abdomen. Once you get the exact position when the sound is loudest, the location is just below the center line of the transducer. This method of locating foetal heart is useful when diagnosing a multiple pregnancy. A better approach for detecting multiple pregnancy is to use two instruments. Since the twins will have out of phase heart beat relation, you can hear two distinct sounds.

» Placenta Localization
The sound from placenta can be distinguished from other sounds as it consists of foetal pulse with howling in the background. The anterior placenta can be located by simple scanning. A placenta located on the posterior wall may be partially or almost totally obscured by the foetus. However, the transducer placed at various positions on the lateral walls rather than the anterior wall may assist in such case.
The peculiar sound from the placenta should be properly heard to avoid confusion between placenta and the umbilical cord, if there is a source of slow moving fluid beneath the cord.

» Intra Uterine Death
Intra uterine death may be confirmed, on placing the probe on various positions on the abdomen, by the complete absence of foetal heart beat or blood flow. Maternal arteries will still be heard, which shows that the instrument is working normally.

GUARANTEE / WARRANTY
This machine is guaranteed for 12 months against any manufacture defect the date of supply.