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All
pregnant women are monitored as a part of prenatal
care. Early prenatal care is important because it gives
your health
care provider a chance to check on your health and the progress
of your pregnancy, and also to keep track of your fetus's growth,
movement, and heartbeat. All women need to attend their prenatal
care appointments even when they are feeling healthy.
Based on the results of routine prenatal care, your health care
provider may suggest further tests to assess the health of the fetus.
Some of these further tests and monitoring may be done with electronic
equipment. Fetal monitoring detects signs of some problems as early
as possible in pregnancy. Although this testing can provide
valuable information, normal results do not guarantee a healthy
baby. All pregnancies carry some degree of risk, and monitoring
does not remove that risk. But it does help your health care provider
to take better care of you and your baby during your pregnancy.
How
Does Monitoring Work?
Some of the
tests used for monitoring check the fetus's movement, heartbeat,
and rate of growth. Some tests show an image of the fetus in the
uterus. Others create
a sound or recording of the fetus's heartbeat. Your health care
provider may combine these tests to capture both sounds and images.
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Special
Tests
Five tests may be used to monitor the well-being of the fetus
before birth:
- Kick
count
- Ultrasound
- Nonstress
test
- Biophysical
profile
Kick
Count
Not all tests require special equipment. For instance, you
can monitor your fetus's movements yourself by keeping a kick
count in late pregnancy.
To record a kick count, you simply note the number of times
the fetus moves over a certain period. Your health care
provider can tell you when and how to perform this test and
what the results might mean. If you do not feel the
fetus does not move in a 12-hour period, let your health care
provider know.
Ultrasound
Ultrasound is a test in which pictures (called sonograms) of the
fetus are created from sound waves. It is used in almost every
major hospital and in many health care providers' offices. From
these pictures, your health care provider can learn about the
fetus and its health.
A small device called a transducer is used to perform an ultrasound
exam. Your health care provider will use either a hand-held transducer,
which is moved along the mother's abdomen, or a vaginal transducer,
which is placed in the vagina. The transducer sends out waves
that are echoed back from the fetus. These waves are then turned
into an image of the fetus on a monitor.
Doppler ultrasound
uses sound waves to create a signal of the fetal heartbeat. In
this case, the sound waves are reflected back in the form of signals
of the fetus's heartbeat. These are shown on a graph rather than
in the form of pictures.
Ultrasound can be used alone or can be combined with other tests
to provide information on the fetus's growth and health. No harmful
effects to either the mother or the fetus have been found in over
20 years of use of this test, although the effects of ultrasound
are still being studied. The long-term risks of ultrasound, if
any, are unknown, but there are many benefits.
Nonstress
Test (NST)
The nonstress test (NST) measures the fetus's heart rate in response
to the movements of the fetus. Usually, the fetus's heart beats
faster when the fetus moves.
This test
is based on the movements of the fetus. A belt is placed around
the mother's waist. Transducers are attached to the belt. The
test usually takes 20-40 minutes. During that time the fetus's
heart rate patterns are measured by Doppler ultrasound.
The mother presses a marker button each time the fetus moves,
or the fetus's movements may be noted by a health care provider
or nurse. A record of the fetus's heart rate is made on graph
paper.
Sometimes the fetus will not move for a short time during the
NST (perhaps as long as 40 minutes). This does not necessarily
mean that there is a problem: most likely, the fetus is
asleep or resting. If this happens, your health care provider
or nurse may try waking the fetus with a buzzer or by having you
eat or drink.
Sometimes
the results of an NST suggest that there is a problem, when in
fact the fetus is healthy. If the nonstress test shows no change
in the fetal heart rate in response to fetal movement, your health
care provider will probably want to do another test to find out
whether the results of the NST are correct.
Biophysical
Profile (BPP)
The biophysical profile (BPP) combines an ultrasound exam with
an NST to give a limited physical exam of the fetus. Usually,
five factors are studied:
-
Heart rate (using the NST)
-
Fetal breathing
-
Fetal body movement
-
Fetal muscle tone
-
Each
of these items is scored, and the total is added. The test may
be repeated, if needed. Your health care provider may use the
score obtained from the BPP to decide whether you need special
care or whether your baby should be delivered early.
Who
Should Get Special Tests?
Depending
on the stage of your pregnancy, your history, and the results of
routine tests, your health care provider may advise that you have
more tests to check the growth and health of the fetus.
Women who have a higher risk of having problems during pregnancy
because of a medical condition need more monitoring than other women.
Some of the conditions that may signal a need for regular prenatal
testing include:
Ultrasound,
the NST, and the BPP provide useful information that will help your
health care provider decide what treatment is best for you. The
goal is to keep you and your baby as healthy as possible.
Finally
. . .
Monitoring
helps you and your health care provider throughout your pregnancy
by giving important information about the well-being of the fetus.
If a test result suggests that there may be a problem, this does
not always mean that the fetus is in trouble. It may simply mean
that you need special care. Discuss any questions you have about
monitoring when you talk with your health care provider during
your regular visits for prenatal care.
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