Types of Electronic Fetal Monitoring
What Do Abnormal Patterns Mean?
Risks
Labor
and delivery can be the most stressful time
of a pregnancy for both mother and baby. Problems may
arise at any point that need attention. Because
of
this, the baby's heart rate is monitored during
labor to check its well-being. Certain changes in the
heart
rate of the baby can signal a problem, so every
woman gets some form of monitoring while she is in
labor.
Most babies will have heart rate changes at
some time during labor and delivery. Fetal
monitoring cannot prevent a problem from occurring,
but it can alert your health care provider to warning
signs. Although no type of fetal monitoring is perfect,
monitoring techniques have improved over the years,
allowing careful assessment of the baby's condition
during labor and delivery.
Fetal
heart rate monitoring is a part of routine
care. Electronic fetal monitoring is a good way
to measure
your baby's responses to labor and delivery.
Electronic fetal monitoring uses equipment to
record the heart
rate on an ongoing basis. At the same time,
the contractions of the uterus are measured.
This can be done by feeling
the abdomen or by using electronic equipment.
Fetal
heart monitoring will be done at different
times depending on your stage of labor and
if you are
at risk for problems. You may be monitored
as often as every 5 minutes or every 30 minutes. Or,
it may be done continuously. Ask your health
care provider about how fetal monitoring will
be used
during your labor.
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Types
of Electronic Fetal Monitoring
Electronic
fetal monitoring uses electronic equipment
to measure the response of the baby's
heart rate to contractions of the uterus.
It
provides an ongoing record that is
reviewed by your health care provider.
Electronic
fetal monitoring is either external or internal:
- External
monitoring requires that two small devices be placed
on the mother's abdomen.
One device uses ultrasound to
detect the fetal heart rate. The other measures
the length of uterine contractions and
the time between them.
- Internal
monitoring can be used only after the membranes
of the amniotic sac have ruptured (that is, after "your water breaks").
A small device called a fetal scalp electrode is
inserted through the vagina and attached to your
baby's scalp. This
device records the heart rate. At the same time,
a thin tube called a catheter may be inserted through
the vagina
into your uterus. The tube measures the strength
of contractions. You may feel some discomfort when
the tube is inserted.
Once it is inserted, though, there is little or
no discomfort.
With both external and internal monitoring,
information about the mother and the baby is recorded by
small machine. The information is printed on a long strip
of paper that is read by your health care provider. You
may need to stay in bed during both types of monitoring,
but you can move around enough to find a comfortable position.
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What
Do Abnormal Patterns Mean?
An
average fetal heart rate varies
between 110 and 160 beats per minute. This is much faster
than your own heart rate, which is about 60-100 beats per
minute.
Changes in the fetal heart rate that occur along with
contractions form a pattern. Certain changes in this pattern
may suggest a problem. One such problem could be that the
umbilical cord, which connects the mother and baby, is being
pinched or squeezed.
If
there is an abnormal fetal heart rate pattern, you
may be:
- Asked
to change positions
- Given
oxygen through a mask
- Given
intravenous fluids
- Given
medication to decrease the strength of contractions
and relax the uterus
- Given
fluids into the uterus.
Abnormal
fetal heart rate patterns do not always mean there is a serious
problem, nor do they point to the exact problem. Other tests
may be used to get a better idea of what is happening with
your baby. Electronic monitoring may be done if abnormal
patterns are found with auscultation. If the baby's heart
rate patterns don't improve, your health care provider may
decide to deliver the baby.
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Risks
There are no
known risks with auscultation or
with external electronic monitoring. With internal electronic
monitoring, there is a small risk of infection.
Women who have a high risk for problems during labor and delivery
will most likely have electronic fetal monitoring. In women who are high
risk or whose babies show an abnormal heart rate pattern with electronic fetal
monitoring,
the delivery of the baby is more likely to be by cesarean birth or with
special instruments (such as forceps or a suction device).
Finally
. . .
Fetal
heart rate monitoring is just one of the many ways
used to check the progress of your labor and the well-being
of your
baby. A number of factors are involved in deciding
what type suits you best. You should discuss
your questions about fetal monitoring with your health
care provider when
preparing for the birth of your baby.
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