Fetal Monitoring
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
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
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.
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
RESOURCES:
American Academy of Family Physicians
http://familydoctor.org/
Women's Health.gov
http://www.womenshealth.gov/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm/
References:
Fetal heart rate monitoring during labor. American College of Obstetricians and Gynecologists website. Available at: http://www.medem.com/ . Accessed August 8, 2005.
Fetal monitoring. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/uvahealth/peds_hrpregnant/fhrm.cfm . Accessed August 8, 2005.
Techniques used to aid delivery. American Medical Association website. Available at: http://www.medem.com/ . Accessed August 8, 2005.
Last reviewed February 2009 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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