Periodic & Continuous Fetal Heart Monitoring
Table of Contents
- 1 What Is Fetal Monitoring?
- 2 Intermittent or Periodic Fetal Monitoring
- 3 Continuous Fetal Monitoring
- 4 When Continuous Electronic Monitoring Is Required?
- 5 What`s Internal Fetal Heart Monitoring?
- 6 What Measures Will Be Taken In Case of Fetal Problems?
- 7 What Is a Fetal Non-Stress Test?
What Is Fetal Monitoring?
Fetal heart monitoring is the constant verification of the baby`s heart rate during labor. In other words, during labor the doctor and a nurse will check the heart rate of the baby to see how he behaves and how he tolerates the mother`s contractions.
Fetal heart monitoring is performed using an electronic fetal monitor – continuous monitoring. While with a Doppler device or fetoscope, the doctor listens to the baby`s heart during prenatal visits – periodic monitoring.
Intermittent or Periodic Fetal Monitoring
Intermittent or periodic monitoring is performed with a Doppler device or fetoscope, which are placed on the pregnant woman`s abdomen during visits to the doctor. He`ll check the contractions by putting his hands on the belly of the future mother.
Read more on How Pregnant Am I?
Periodic monitoring is done every 15 – 30 minutes in the active phase of the first stage of labor and every 5 minutes during the second phase (push phase). The doctor will monitor the baby`s heart rate during contractions when the baby doesn`t move to determine the “average” pulse rate (normal is between 110 and 160 beats per minute). Also, the medical personnel that attends the birth process will check the baby`s heart rate during contractions and immediately after to see how he tolerates the mother`s contractions. If the doctor will suspect a problem, the heart rate of the baby will be checked more often; it may even reach to a continuous monitoring throughout labor.
Fetal heart rate will be checked when water breaks or immediately after a vaginal control.
Continuous Fetal Monitoring
Continuous fetal monitoring is performed using 2 electronic disks (sensors), known as transducers, which are held on the abdomen by an elastic band. One of the disks will monitor the baby`s heart rate, while the other the maternal contractions. The transducers are connected to a device that is near the bed.
Electronic fetal heart monitoring isn`t painful at all, hut some mothers have claimed it`s inconvenient to have 2 disks on their belly during labor. Additionally, the pregnant woman`s movements are limited and the future mother will barely be able to handle the contractions.
Experts cannot agree regarding the comparative advantages of the 2 methods of fetal monitoring. While some studies cannot associate electronic fetal heart monitoring with a significant improvement of Apgar score or a reduction of newborn deaths, other studies who exactly the opposite.
Also, the false-positive readings are common, which show a problem that in fact isn`t there. For the mother, continuous monitoring is associated with a lot of C-sections or assisted deliveries (using forceps and vacuum).
When Continuous Electronic Monitoring Is Required?
Electronic monitoring is needed in certain cases, such as:
- Complications in pregnancy or labor.
- In case the pregnant woman chooses to make an epidural to reduce pain during delivery.
- In case the pregnant woman needs oxytocin (pitocin) to induce labor or speed it up.
In case the pregnancy went well and there are no complications during labor, the American Congress of Obstetricians and Gynecologists, experts from the European Union as well as other well known doctors recommend that the monitoring of the fetus should be kept periodic, because there`s no sufficient evidence to show continuous monitoring has any positive effect on the baby, on the contrary – it`s easier for this to lead to Caesarean.
What`s Internal Fetal Heart Monitoring?
In case that external monitoring isn`t efficient (it happens in case that the pregnant woman moves a lot or she`s obese) or the doctor thinks that is necessary to have a more precise monitoring, he may recommend or decide to perform an internal monitoring of the baby.
Internal fetal heart monitoring is an invasive procedure which involves inserting a sensor through the cervix – an electrode – that will be attached to the baby`s scalp. The sensor will be connected to an external monitor and offer more accurate results to the baby`s heart rate. – More info!
Also, your doctor might decide inserting a catheter through the cervix so he can monitor your uterine contractions.
What Measures Will Be Taken In Case of Fetal Problems?
The doctor who assists the pregnant woman in birth will evaluate the results of the fetal monitoring and in case there are any issues, he may decide:
- To change the position and administer oxygen and fluids.
- To stop administering oxytocin, in case labor is induced.
- Adding drugs to relax the uterus and reduce the contractions.
- Infusing a sterile fluid into the uterus through a thin catheter, in case the membranes are broken.
- Caesarean or assisted birth, if the child`s condition worsen.
If you experiencing an electronic fetal heart monitoring and don’t hear the baby`s heartbeat, don’t panic; it`s possible for the transducer on your abdomen to have moved from its place and no longer be in contact with the baby`s heart rate. A nurse will resolve this issue.
What Is a Fetal Non-Stress Test?
The non-stress fetal test is generally performed when the pregnant woman exceeded 40 weeks of pregnancy. This test can be done preventively, starting with the week 38 of pregnancy, when the mother had issues with previous births or she experiences certain risk factors.
The non-stress test is noninvasive and is performed in the obstetrician`s office using a fetal monitoring equipment – a special belt attached to the abdomen and a monitor that will record the baby`s heart rate and its modifications according to any uterine activity. Involved risks: misinterpretation of data and exposure to ultrasound. – Check this!
The Alternatives of the Non-Stress Test Are Stress Tests or Biophysical Profile
Stress tests are pretty dangerous (they may trigger premature labor) and are done by injecting a small amount of oxytocin to see if the fetus can face the mother`s contractions.
The biophysical profile is a combination of a thorough ultrasound and a non-stress test. This test is done preventively or when the mother has several risk factors. The biophysical profile is performed between weeks 38 and 42 of pregnancy and will monitor the baby`s heart rate, breathing, muscle tone, amniotic fluid.
The external fetal heart monitoring can be performed during pregnancy at any of the routine visits to the doctor and using the same instruments and methods.