Fetal heart monitoring

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Fetal heart and uterine contraction monitor

Internal fetal monitoring

Fetal heart monitoring lets the health care provider monitor the baby's heartbeat in the uterus, including during labor. The procedure can be done with monitors outside the body (external monitoring) or in the uterus (internal monitoring).

Nonstress test; Contraction stress test; Scalp monitoring

EXTERNAL FETAL MONITORING

By definition, external fetal monitoring is done through the skin and is not meant to be invasive. You will sit with knees and back partially elevated with a cushion under the right hip, which moves your uterus to the left. You can also sit in other comfortable positions, as long as your uterus is shifted to the left or, for brief periods, to the right.

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Sensitive electrodes (connected to monitors) are placed on your abdomen over conducting jelly. The electrodes can sense the fetal heart rate (FHR) and the presence and duration of uterine contractions. Usually, the results of this test are continuous and are printed out, or they appear on a computer screen. External monitors, however, cannot tell how strong contractions are.

This allows your health care provider to check if your baby’s pattern is one seen in healthy babies, and how well the baby is tolerating the contractions. The decision to move to internal fetal monitoring is based on the information first obtained by external fetal monitoring.

NONSTRESS TEST

The nonstress test is another way of externally monitoring your baby. The nonstress test can be done as early as the 27th week of pregnancy, and it measures the FHR accelerations with normal movement. For this test, you will sit with knees and back partially elevated with a cushion under the right hip, which moves your uterus to the left.

The same monitors described above are placed on your abdomen to measure the FHR pattern and whether the uterus is contracting. If there is no fetal heart rate reactivity after 30 - 40 minutes (indicated by a rise in the baby’s heart beat above its baseline with fetal movement), you will be given something to drink or a small meal which may stimulate fetal activity. Other interventions that might encourage fetal movement include the use of fetal acoustic stimulation (sending sounds to the fetus) and gently placing your hands on your abdomen and moving the fetus.