Medical Health Encyclopedia

Fetal heart monitoring

CONTRACTION STRESS TEST (CST)

The CST is a final method of externally monitoring your baby. This test measures the ability of the placenta to adequately oxygenate the fetus under pressure (contractions).

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 uterine contractility and FHR. If contractions are not occurring spontaneously, either a medication (called oxytocin) will be given intravenously, or nipple stimulation will be used to induce contractions.

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If oxytocin is administered, it is called the oxytocin challenge test (OCT). Oxytocin is administered through an IV until three uterine contractions are observed, lasting 40 to 60 seconds, over a 10-minute period.

A test involving nipple stimulation is called the nipple stimulation contractions stress test. Every effort will be taken to ensure your privacy, but the nurse will be with you through the entire procedure.

After being positioned as described above, you will rub the palm of your hand across one nipple through your garments for 2 to 3 minutes. After a 5-minute rest, the nipple stimulation should continue until 40 minutes have elapsed, or 3 contractions have occurred, lasting more than 40 seconds, within a 10-minute period. If a uterine contraction starts, you should stop the nipple stimulation.

INTERNAL FETAL MONITORING

Internal fetal monitoring involves placing a electrode directly on the fetal scalp through the cervix. Your health care provider may use this method of monitoring your baby if external monitoring is not working well, or the information is suspicious.

A vaginal examination will be performed, and the electrode will be introduced with its plastic sheath into the vaginal canal. This plastic guide is moved through the cervix and placed on the fetus' scalp, then removed. The electrode's wire is strapped to your thigh, and attached to the monitor.