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Definition

Fetal monitoring is done to monitor how your baby is doing during labor and delivery. Different methods of fetal monitoring can be used to listen to the fetus’s heartbeat and to measure uterine contractions.

Parts of the Body Involved

Depending on whether fetal monitoring is done externally or internally, it may involve different parts of the body:

  • Mother’s abdomen
  • Mother’s vagina
  • Mother’s uterus
  • Fetus’s scalp

Reasons for Procedure

To ensure the fetus is not under excess stress during labor and delivery

Risk Factors for Complications During the Procedure

None

What to Expect

Prior to Procedure

As you prepare for the birth of your baby:

  • Discuss with your doctor how the fetus will be monitored (external or internal) and how often (continuous or intermittent)
  • Work with your doctor and labor support partner to come up with a “birth plan." This plan will help you to think about:
    • What you would like to happen
    • How you can adjust to labor if a complication occurs during labor and delivery

Description of the Procedure

There are two types of fetal monitoring:

External Fetal Monitoring

There are two types of external monitoring:

  • The doctor places gel on your abdomen, then places two belts around your abdomen. One is to monitor your baby’s heartbeat, and the other is to measure the length, intensity, and frequency of your contractions. The fetus’s heart rate is displayed on a screen and printed on special paper.
  • The doctor uses a fetoscope (similar to a stethoscope) to listen to the baby's heart rate. Fetoscopes are not used as often today because external doppler]]> devices can be used instead.

External Fetal Monitoring

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Internal Fetal Monitoring:

There are two types of internal monitoring:

  • Internal fetal monitoring can only be done after your water has broken and your cervix has partially dilated. Your doctor inserts a small electrode through your vagina and into your uterus. The electrode is attached to the fetus’s scalp to measure fetal heart rate.
  • To measure the length, intensity, and frequency of your contractions, your doctor may insert a long, thin pressure catheter through your vagina into your uterus.

After Procedure

If gel was applied to your abdomen, the nurse will clean it off. This usually happens after the baby is born and monitoring is no longer necessary.

How Long Will It Take?

Fetal monitoring may either be performed at set times throughout your labor and delivery or continuously during active labor. The length of labor and delivery is extremely variable from woman to woman. On average, a first baby is born 12-14 hours after active labor begins.

Will It Hurt?

No

Possible Complications

Most types of external fetal monitoring pose no known risks to the mother or fetus. There are, however, slight risks associated with internal monitoring:

  • Infection during labor
  • Small cut on the baby’s head when an electrode is attached to the scalp (This cut heals quickly.)

Average Hospital Stay

Fetal monitoring itself requires no hospital stay. The average hospital stay after labor and delivery is 0-2 nights.

Postoperative Care

Most fetal monitoring requires no aftercare. If you have any complications, your doctor will give you instructions.

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Outcome

The average fetal heart rate is 110-160 beats per minute. An abnormal heart rate or pattern may indicate that the fetus is not getting enough oxygen or having other problems. If complications occur during external fetal monitoring, your doctor may recommend internal fetal monitoring, which can be more accurate. If internal fetal monitoring determines your baby is under excessive stress or is having difficulty, your doctor may recommend a cesarean section]]> .

Call Your Doctor If Any of the Following Occurs

After you leave the hospital, call your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the site where the electrode was attached to your baby