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Fetal Heart Rate Monitoring

Definition

Fetal heart rate monitoring is listening to your baby's heartbeat.

Reasons for Test

Monitoring is done before labor to evaluate the well-being of the fetus during pregnancy. It can also be used during labor and delivery. This gives your doctor information about how well your baby is handling the stress of labor.

Possible Complications

There are no major complications associated with external monitoring. Internal monitoring may increase the risk of infection. There may also be some bruising on the baby's scalp. Internal monitoring is not recommended in mothers with a current herpes infection.

What to Expect

Prior to Test

As you prepare for the birth of your baby:

  • Discuss with your doctor how the fetus will be monitored (external or internal) and how often (continuous or occasionally).
  • Work with your doctor and labor support partner to come up with a birth plan. This plan will help you to think about:
    • What you would like to happen
    • How you can adjust if a complication occurs during labor and delivery

Description of the Test

There are two types of fetal monitoring:

External Fetal Monitoring

There are two ways your doctor can monitor your baby externally:

  • The doctor places gel on your abdomen. Two belts are placed around your abdomen. One is to monitor your baby’s heartbeat, and the other is to measure the quality of your contractions. Your baby's heart rate is displayed on a screen and printed on special paper.
  • The doctor uses a fetoscope (similar to a stethoscope) to listen to the baby's heart rate.

External Fetal Monitoring
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Internal Fetal Monitoring:

Internal fetal monitoring is only used during labor. It can only be done after your water has broken and your cervix has started to dilate. Your doctor inserts a small electrode through your vagina and attaches it to the baby's scalp. The electrical signals from your baby's heartbeat are picked up by the electrode and displayed on a screen. This type of monitoring is more accurate than external monitoring. The electrode will not injure your baby. However, the use of internal fetal monitoring should be avoided in certain maternal and fetal conditions.

After Test

The electrodes or belts will be removed.

How Long Will It Take?

Fetal monitoring may be done at set times throughout your labor and delivery or throughout active labor.

Will It Hurt?

No

Results

The average fetal heart rate is 110-160 beats per minute. An abnormal heart rate or abnormal pattern may indicate that the fetus is not getting enough oxygen or having other problems. The doctor may change the course of your labor and delivery based on what the fetal heart rate is showing.

Call Your Doctor

The procedure is completed with labor. There are no lasting effects that your doctor will need to monitor.

Revision Information

  • American Academy of Family Physicians

    http://familydoctor.org

  • American Congress of Obstetricians and Gynecologists

    http://www.acog.org/For%5FPatients

  • WomensHealth.gov

    http://www.womenshealth.gov

  • Health Canada

    http://www.hc-sc.gc.ca

  • Women's Health Matters

    http://www.womenshealthmatters.ca

  • Antepartum Fetal Surveillance. The American College of Obstetricians and Gynecologists, Practice Bulletin No. 9 . October 1999 (Reaffirmed 2009).

  • External and internal heart rate monitoring of the fetus. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/gynecology/external%5Fand%5Finternal%5Fheart%5Frate%5Fmonitoring%5Fof%5Fthe%5Ffetus%5F92,P07776 . Accessed December 20, 2012.

  • Fetal heart rate monitoring during labor. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq015.pdf?dmc=1&ts=20121220T0954532535 . Accessed December 20, 2012.