| Fetal monitoring | 402.000000000000 | Fetal monitoring | Fetal monitoring | F | English | Pregnancy | Adult (19+) | Body;Uterus | Reproductive system | NA | Prenatal
Adult (19+) | NA | | 2009-09-11T04:00:00Z | | | | | | 11.8000000000000 | 42.7000000000000 | 1103.00000000000 | | Flat Content | Health A-Z | <p>Read about external and internal fetal monitoring during pregnancy. Intermittent auscultation is also discussed.</p> | <p>Fetal monitors are used to assess the baby’s heart rate and the contractions of the uterus during pregnancy and childbirth. The main objective of fetal heart rate monitoring is to monitor the well-being of the baby. There are two types of fetal monitoring: external and internal. Both types of monitor trace a pattern of the baby’s heart rate and the mother’s contractions onto a strip of graph paper. In childbirth, external fetal monitoring can be done either continuously throughout labour or intermittently. <br></p> | | <h2>Key points</h2>
<ul><li>External fetal monitoring can be done at any time during pregnancy.</li>
<li>An internal fetal monitor is a small electrode placed on the baby's scalp can only be put into position after the mother’s fetal membranes have broken.</li>
<li>The use of continuous fetal monitoring during childbirth is controversial because the accuracy of the technology is still quite limited.</li></ul> | <p>An unborn baby’s heart rate usually ranges from 110 to 160 beats per minute. A higher heart rate is a frequent response to fever or infection. A slower heart rate could indicate oxygen deprivation in the baby or, less commonly, a heart problem in the baby. A prolonged decline in heart rate below 110 beats per minute is a sign of possible distress that needs to be dealt with quickly.</p><h2>External fetal monitoring</h2><p>External fetal monitoring can be done at any time during pregnancy or childbirth. An external fetal monitor is a small round ultrasound disc that measures high speed sound waves. Ultrasound gel is rubbed on the mother’s abdomen and the disc placed on top. The disc may be held in place with a light stretchable belt if the monitoring is continuous, or it can be held in place by the health-care provider for short periods of time if the monitoring is intermittent. The ultrasound disc measures the baby’s heart rate. At the same time, during labour, if the monitoring is continuous, a pressure-sensitive device is strapped under another stretchy belt, and this device measures the intensity of the mother’s contractions. An external contraction monitor can keep track of the frequency of contractions and how long they are lasting. It may be difficult to use external monitoring to detect contractions in obese women. </p><h2>Internal fetal monitoring</h2><p>An internal fetal monitor is a small electrode placed on the baby’s scalp, and is used to monitor the baby’s heart rate more closely. An internal fetal monitor can only be put into position after the mother’s fetal membranes have broken. If the strength of the mother’s contractions needs to be monitored, this can also be done using an internal monitor. This consists of a thin, catheter-shaped device that is placed on the uterus. This device brings with it a risk of infection, and therefore it should only be used when absolutely necessary. </p><h2>Fetal monitoring during pregnancy</h2>
<p>During pregnancy, external fetal monitoring is normally offered when there is a health concern with the baby. External fetal monitoring is used in non-stress testing, where the response of the unborn baby’s heart to certain movements is observed. External fetal monitoring can also be used in stress testing, where the mother is given oxytocin to induce contractions, and the response of the baby’s heart rate to the contractions is assessed. Some reasons to conduct external fetal monitoring during pregnancy are as follows:</p><ul><li>conditions in the mother such as diabetes mellitus, systemic lupus erythematosus, or chronic hypertension </li><li>conditions in the unborn baby such as fetal growth restriction or rhesus (Rh) hemolytic disease </li><li>pregnancy complications such as too little amniotic fluid in the womb </li><li>the presence of twins or multiple babies </li></ul><h2>Fetal monitoring during childbirth</h2><p>In childbirth, the use of continuous fetal monitoring is controversial. This is because the accuracy of the technology is still quite limited. Fetal monitors can be misread, and they can sometimes register a problem with the baby’s heart rate when none really exists. The high false-positive rate of continuous fetal monitoring during childbirth has led to an increased incidence of unnecessary caesarean section. For this reason, it is recommended that continuous fetal monitoring only be used in high-risk births. </p><p>Regardless, continuous external fetal monitoring throughout labour is still used in many births in North America. A number of health-care providers see this as a useful tool for assessing the baby’s heart rate and the mother’s contractions. </p><p>More commonly, a woman in labour will be given 20 minutes of continuous external fetal monitoring as an initial assessment of her contraction pattern and how the baby is tolerating labour. If the baby seems to be in good condition, if their heart is in the normal range and shows good variation without slowing, and if they appear to be tolerating labour well, the external fetal monitor may be removed. Once this monitor is removed, the health-care team will continue to check the baby's heart rate at regular intervals, and this is called intermittent auscultation. </p><h3>Intermittent auscultation</h3><p>In low-risk women, intermittent auscultation is recommended instead of continuous external fetal monitoring throughout labour. In intermittent auscultation, the health-care provider checks the baby's heart rate at regular intervals. Auscultation literally means checking with a stethoscope. However, the baby's heart rate is likely to be checked using a Doppler instrument or another listening device called a fetoscope. A normal heart rate is between 110 to 160 beats per minute.</p><p>Typically, the health-care provider will place their hands on the woman's abdomen and feel the uterus from the beginning to the end of the contraction, and will listen to the baby's heart rate in relation to that contraction. They may also assess the contractions by checking to see if the cervix is dilating.</p><p>In early labour, intermittent auscultation is done every 30 minutes. This interval increases to every 15 minutes during active labour, and at least every five minutes during the pushing phase. If the baby develops an abnormal heart rate, the health-care provider may then decide to switch to continuous external or internal fetal monitoring. </p><p>There are a number of benefits to intermittent auscultation. First, when mothers are not being monitored, they are free to walk and move around. They can shower and do other things to try to remain comfortable during labour. In contrast, if they are hooked up to a continuous external fetal monitor throughout labour, they need to remain in or near the bed. Intermittent auscultation also helps a woman experience a more natural birth experience, since they are not hooked up to a machine throughout labour. Last but not least, intermittent auscultation appears to reduce the chance of having a caesarean section. </p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/fetal_monitoring.jpg | | | | | | | Fetal monitoring | | False | | | | | | | | |
