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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
External Electronic Fetal Monitoring
What is external electronic fetal monitoring?
Electronic fetal monitoring measures the baby's heart rate
and the mother's contractions during labor. External fetal
monitoring uses instruments placed on the mother's abdomen.
The instruments produce graphs that can be viewed on a
screen. This information helps your health care provider
know how the baby is doing during labor.
When is it used?
Continuous electronic fetal monitoring is used during labor
in all high-risk pregnancies. In low-risk pregnancies,
electronic monitors may be used for about 20 minutes at the
start of labor, for a few minutes each hour, or all the
time.
Continuous electronic monitoring is needed with
complications such as:
- preterm labor
- births of more than one baby, such as twins
- bleeding during labor
- changes in the baby's heart rate found with the
stethoscope
- a very long or very fast labor
- diabetes or other medical disease
- high blood pressure.
What happens during the procedure?
The devices for external fetal monitoring are held in place
by two belts around the mother's abdomen. On one belt is a
pressure gauge, which records the pressure of the
contractions. Attached to the other belt is a small
ultrasound instrument that records the baby's heart rate.
Monitoring is safe and fairly comfortable. You can change
positions while the devices are in place, but movement can
sometimes disrupt the test recording.
When the baby's heart rate is normal, the monitor may be
disconnected at times. You can then move more freely.
During most labors the monitor is attached for a few minutes
each hour. When the monitor isn't being used, your health
care provider may use a stethoscope to check the baby's
heart rate every 15 minutes after a contraction.
If the monitor shows that the baby's heart rate is abnormal
or your contractions are too frequent, an internal monitor
may be used for more accurate information. Internal
monitors use an instrument that goes into your uterus and
one that is connected to the baby's scalp.
A heart rate that is too slow or does not change as
it should with contractions may mean that the baby is not
getting enough oxygen. Your doctor may decide that the
baby may not do well in a normal vaginal delivery. You may
need to have a cesarean section (C-section).
What are the benefits of this procedure?
Electronic fetal monitoring allows your health care provider
to check the baby's response to labor. If the baby is not
doing well, steps may be taken to help the baby.
What are the risks associated with this procedure?
There are no known serious complications from external
electronic monitoring when it is used properly.
Sometimes the information from an external monitor is not
completely accurate. This may require the placement of an
internal monitor. At all times the monitoring should be
evaluated by health care providers who are trained in
interpreting it. They need to be able to weigh carefully
the many other factors in labor that determine how well the
baby is doing.
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