Fetal Heart Monitoring During Labor

What is Fetal Heart Monitoring?

Fetal heart monitoring is done during pregnancy, labor, and delivery to keep track of the heart rate of your baby (fetus) and the strength and duration of the contractions of your uterus. Your baby’s heart rate is a good way to tell whether your baby is doing well or may have some problems.

Why is fetal heart rate monitoring done during labor and delivery?

Most babies make it through labor without any problems but there are a few who do not manage as well. During contractions
(tightening of the womb) blood cannot get through the placenta very easy. This is normal and most babies manage without any problems. If a baby is not managing well, this can be seen in the pattern of the baby’s heartbeat on the fetal monitor.

What are the types of fetal heart monitoring?

There are two ways to do fetal heart rate monitoring during labor Auscultation and Electronic Fetal Monitoring.

• Auscultation is a way of listening to the baby’s heartbeat along with measuring the strength of uterine (womb) contractions.
• Electronic Fetal Monitoring (EFM) is a procedure that uses different tools to record the heartbeat of the baby and the contractions of the mother’s uterus during labor.

Auscultation and EFM can be done at set times through labor. EFM may be used non-stop based on your baby’s response to labor. The type of fetal monitoring used depends on how your labor is progressing and your risk of problems.

How is auscultation performed?

Auscultation involves listening to your baby’s heartbeat at set times. There are two ways of listening to the baby’s heartbeat with auscultation:

• Doppler device: is a small device that is pressed against your abdomen. It is form of ultrasound that uses sound waves to listen to your baby’s heartbeat
• Pinards: a special device like a stethoscope is placed at the ear of your nurse or doctor.    The open end is pressed on your abdomen (belly) to listen to your babies heart

How is electronic fetal monitoring performed?

Electronic fetal monitoring uses special equipment to measure your baby’s heart rate through the
labor process. First the nurse or doctor will feel your belly to check the position of your baby. This will allow them to find your baby’s heart rate more accurately. Electronic fetal monitoring can be external (outside), internal (inside), or both.

External monitoring
A pair of special belts are wrapped around your abdomen (belly). A device called a transducer will pick up your baby’s heartbeat and record it on a graph. Uterine contractions can also be recorded with external monitoring.

Internal monitoring
A small device called an electrode is inserted through the vagina and placed on the baby’s scalp. This device records the heart rate on a graph. Uterine contractions can also be recorded with an internal monitor called an intrauterine pressure catheter.

What happens if the baby’s fetal heart rate pattern is abnormal?

If your baby’s heart rate is abnormal other test can be done to measure your baby’s health. If other testing suggests there are problems with your baby, the nurse and doctor will discuss your options to help deliver your baby safely.