Johns Hopkins Medicine. Fetal heart monitoring. Updated A comprehensive feature analysis of the fetal heart rate signal for the intelligent assessment of fetal state. The risks and benefits of internal monitors in laboring patients. Heelan L. Fetal monitoring: Creating a culture of safety with informed choice. J Perinat Educ. Your Privacy Rights. To change or withdraw your consent choices for VerywellFamily. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page.
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You might need continuous fetal monitoring if you: Are experiencing fetal distress in your current labor Are having an epidural Are having an induction of labor Have certain medical conditions Have had a previous cesarean birth Have had multiple babies. A Word From Verywell When you're in labor, fetal monitoring helps your healthcare team monitor how your baby is coping. How Internal Fetal Monitoring Works. Was this page helpful? Thanks for your feedback!
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Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear. The consent form for fetal heart rate monitoring may be included as part of the general consent for your labor and birth.
If fetal heart rate monitoring is performed in conjunction with another monitoring procedure, such as a nonstress test or biophysical profile, you may be asked to eat a meal before the procedure. This can help increase fetal activity. You may or may not be able to eat or drink with fetal heart rate monitoring during labor. Although the gel applied to the skin during the procedure does not stain clothing, you may wish to wear older clothing or a hospital gown, as the gel may not be completely removed from your skin afterwards.
Placement of an internal electrode requires that the amniotic membranes the fluid-filled sac that surrounds the fetus during pregnancy be broken, and the cervix be dilated opened several centimeters to allow contact with the fetal scalp or other body part.
Based upon your medical condition, your physician may request other specific preparation. Fetal heart rate monitoring may be performed in your physician's office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your hospital's practices.
Depending on the type of procedure, you may be asked to expose your abdomen, undress from the waist down, or undress completely and put on a hospital gown. The transducer will be pressed against the skin and moved around until the fetal heartbeat is located. You will be able to hear the sound of the fetal heart rate with Doppler or an electronic monitor. During labor, the fetal heart rate may be monitored intermittently or continuously, depending on your condition and the condition of your fetus.
For continuous electronic monitoring, the transducer will be connected to the monitor with a cable. A wide elastic belt will be placed around your back to secure the transducer in place. The fetal heart rate will be recorded in the medical record. With continuous electronic monitoring, the fetal heart pattern will be displayed on a computer screen and printed onto graph paper.
You may or may not be allowed to get out of bed with continuous external fetal heart rate monitoring. Once the procedure has been completed, the transducer will be removed and the gel will be wiped off. You will be asked to undress completely and put on a hospital gown, and lie on a labor bed, with your feet and legs supported as for a pelvic exam.
The physician or nurse will perform a vaginal examination with a gloved hand to check cervical dilation the amount the cervix has opened. This may be slightly uncomfortable. If the amniotic sac is still intact, your physician may break open the membranes with an instrument. You will feel warm fluid coming out of your vagina. The physician will feel the part of the fetus at the cervical opening with gloved fingers - this is usually the fetus head. A long, plastic electrode guide will be inserted into your vagina.
A small spiral wire at the end of the electrode will be placed against the fetal part and gently rotated into the fetal skin.
The guide will be removed and the electrode will be left in place, attached to the fetal part. Your provider may use internal monitoring when external monitoring is not giving a good reading. Or your provider may use this method to watch your baby more closely during labor. Your provider will note how often you are having contractions and how long each lasts.
Because the fetal heart rate and contractions are recorded at the same time, these results can be looked at together and compared. Your provider may check the pressure inside your uterus while doing internal fetal heart monitoring. To do this, he or she will put a thin tube catheter through your cervix and into your uterus. The catheter will send uterine pressure readings to a monitor.
Fetal heart rate monitoring is especially helpful if you have a high-risk pregnancy. Your pregnancy is high risk if you have diabetes or high blood pressure. It is also high risk if your baby is not developing or growing as it should. Fetal heart rate monitoring may be used to check how preterm labor medicines are affecting your baby. These are medicines are used to help keep labor from starting too early. You may find the elastic belts that hold the transducers in place slightly uncomfortable.
These can be readjusted as needed. You must lie still during some types of fetal heart rate monitoring. You may need to stay in bed during labor. With internal monitoring, you may have some slight discomfort when the electrode is put in your uterus. Note: You should not have internal fetal heart rate monitoring if you are HIV positive.
This is because you may pass the infection on to your baby. You may have other risks depending on your specific health condition. Be sure to talk with your provider about any concerns you have before the procedure.
Certain things may make the results of fetal heart rate monitoring less accurate. These include:. You may have fetal heart rate monitoring in your healthcare provider's office or as part of a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider's practices.
You do not need any special care after external fetal heart monitoring. You may go back to your normal diet and activity unless your healthcare provider tells you otherwise. The provider will clean the site with an antiseptic. Health Home Treatments, Tests and Therapies. Why might I need fetal heart monitoring? Fetal heart rate monitoring may be used in other tests, including: Nonstress test. This measures the fetal heart rate as your baby moves.
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