External Monitoring: Pregnancy Insights And Fetal Health

External monitoring during pregnancy involves checking the health of the unborn baby by tracking its heart rate and other functions. This is typically done using a fetoscope, a stethoscope with a different shape, or a Doppler, an electronic tool that uses sound waves and a computer. Sensors are placed on the mother's belly and held in place with elastic bands, recording the baby's heart rate and uterine contractions. External monitoring is the most common method of fetal monitoring and is generally safe, non-invasive, and painless. It can help identify potential problems and determine if further testing or interventions, such as a C-section, are needed. However, it has limitations and does not guarantee perfect health outcomes.

External monitoring can be done with a fetoscope or Doppler

External monitoring is a very common procedure that can be carried out in two ways: externally, on the outside of the belly, or internally, directly on the baby while inside the uterus. External monitoring can be done with a fetoscope or Doppler.

Fetoscope

The fetoscope is a specially-designed stethoscope that amplifies internal sounds, allowing care providers and parents-to-be to listen to the fetal heart rate. It is a vital part of prenatal care, increasing the connection between a mother and baby. The fetoscope can also help determine or confirm fetal positioning, as the sound of the heartbeat is always loudest when placed directly over the heart.

The best time to start using a fetoscope is around 18–22 weeks into the pregnancy as many won't be able to hear a heartbeat earlier than that. It does not require an ultrasound machine or battery power to hear an amplified fetal heartbeat. Instead, one must be specific, patient, and listen attentively to identify the acoustic sound of the baby’s heartbeat.

Doppler

Doppler ultrasound uses sound waves to detect the movement of blood in vessels. It is used in pregnancy to study blood circulation in the baby, uterus, and placenta. It is the most basic type of fetal monitoring and is often done during prenatal visits to count the fetal heart rate. Doppler ultrasound may also help show problems in the baby during late pregnancy and labour.

Internal monitoring requires a small wire to be attached to the baby's head

Fetal monitoring is a common procedure used to check the health of an unborn baby during pregnancy and labour. Monitoring is done by checking the baby's heart rate and other functions. Typically, this is done by a doctor or healthcare provider.

There are two types of fetal monitoring: external and internal. External monitoring is done on the outside of the mother's belly and can be performed using a fetoscope (a specially designed stethoscope) or a Doppler (an electronic tool that uses sound waves and a computer). This type of monitoring is typically used during routine check-ups and is considered safe, non-invasive, and risk-free.

Internal monitoring, on the other hand, is done directly on the baby while inside the uterus (womb). It requires a small wire, called an electrode or electronic fetal scalp electrode, to be attached to the baby's head. This wire is guided through the mother's vagina and cervix and then connected to a monitor. The procedure can only be performed if the amniotic sac has ruptured and the cervix is dilated.

Internal monitoring is considered more accurate than external monitoring in tracking the beat-to-beat variability of the baby's heart rate. It is often used in high-risk pregnancies or when there are difficulties in picking up the baby's heartbeat with external monitoring. However, it does carry some risks, including a slight risk of infection, and the possibility of bruising, scratching, or leaving a mark or small cut on the baby's scalp.

The decision to use internal or external monitoring depends on various factors, including the mother's and baby's health, the stage of pregnancy or labour, and the availability of resources. It is important for pregnant individuals to discuss these options with their healthcare providers and ask questions to make informed decisions.

Fetal monitoring can be continuous or periodic

Fetal monitoring is a common procedure used to check the health of the unborn baby and can be performed during pregnancy and labour. Monitoring can be done externally or internally. External monitoring is the most common form of continuous monitoring. Sensors are placed on the mother's belly and held in place with elastic bands. The sensors are connected to a machine that records the baby's heart rate and uterine contractions. External monitoring can also be done with a fetoscope (a stethoscope with a different shape) or a Doppler, which is an electronic tool that uses sound waves and a computer.

Internal monitoring is used in high-risk cases or when there are problems picking up the baby's heartbeat with the external monitor. A thin electrode is guided through the vagina and cervix and attached to the baby's scalp. A small tube is also inserted to monitor the contractions inside the uterus. The electrode and tube are attached to a device that continuously records the baby's heart rate.

Fetal monitoring can also be continuous or periodic. Continuous monitoring involves the use of an electronic fetal monitor that is attached to the mother's abdomen with stretchy bands. It monitors the baby's heartbeat and tracks contractions. This method is typically used for high-risk pregnancies or when labour is induced or augmented with medication. Periodic monitoring, also known as intermittent auscultation, is done with a handheld Doppler device, an external fetal monitor probe, or a fetoscope. The provider will check the baby's heartbeat at specific intervals, usually every 15 to 30 minutes in the active phase of the first stage of labour and every five to 15 minutes during the second stage.

For low-risk pregnancies, experts agree that continuous monitoring is unnecessary, and periodic monitoring is just as effective. Continuous monitoring in low-risk pregnancies can increase the risk of false readings, leading to unnecessary procedures such as C-sections and assisted deliveries. However, some studies have found that babies may be marginally safer when monitored continuously.

Monitoring can be done during pregnancy and labour

External Monitoring

External monitoring is done on the outside of the belly and is the most common method of monitoring. Sensors are placed on the belly and held in place with elastic bands. This method is usually used for women with low-risk pregnancies. It can be done with a special tool called a fetoscope, which is a stethoscope that has a different shape, or with a Doppler, which is an electronic tool that uses sound waves and a computer. External monitoring is not risky and does not cause any pain or use radiation.

Internal Monitoring

Internal monitoring is done directly on the baby while inside the uterus. A small wire (electrode) is put on the baby's head while they are still inside the uterus. This method is used in high-risk cases or when there are problems picking up the baby's heartbeat with external monitoring. It requires the amniotic sac to be ruptured and the cervix to be dilated. There is a slight risk of infection with internal monitoring, and it may cause a mark or small cut on the baby's head.

Monitoring is typically done later in the pregnancy and during labour. For external fetal monitoring during pregnancy, the mother may need to have a full bladder. There are no restrictions on food or drink. For fetal monitoring during labour, the healthcare provider will advise if any preparation is needed.

Monitoring is done to check the baby's heart rate and other functions. It helps determine the strength and duration of contractions and can alert doctors to potential problems. A baby's heart rate during labour should be between 110 and 160 beats per minute, but it may fluctuate above or below this rate for various reasons. An abnormal heart rate may indicate that the baby is not getting enough oxygen or that there are other problems.

Fetal monitoring is a very common procedure

There are two main types of fetal monitoring: external and internal. External monitoring is the most common type and is typically used for low-risk pregnancies. It involves placing sensors on the mother's belly, which are held in place with elastic bands. These sensors record the baby's heart rate and uterine contractions. This method is generally effective, but in some cases, a clear reading may not be possible due to factors such as the mother's weight or the baby's position.

Internal monitoring, on the other hand, is used in high-risk cases or when there are difficulties picking up the baby's heartbeat with external monitoring. It involves inserting a thin electrode through the vagina and cervix to attach it to the baby's scalp. This method provides a more accurate reading of the baby's heart rate but carries a slight risk of infection and may cause minor marks or cuts on the baby's head.

Fetal monitoring is typically recommended for high-risk pregnancies or when there are specific concerns about the baby's health. For example, it may be used when the mother is taking medication for preterm labour or when the baby is not growing or developing normally. It can also be used to assess the need for further testing or interventions, such as a C-section.

While fetal monitoring is a valuable tool, it has some limitations. For instance, it has been linked to an increased likelihood of vacuum and forceps use, as well as C-section deliveries. Additionally, false-positive readings, which indicate a problem when the baby is actually fine, are common. Therefore, it is essential to consider other factors besides heart rate when determining the baby's wellbeing.

In conclusion, fetal monitoring is a common and important procedure during pregnancy and labour. It helps ensure the baby's health and wellbeing, but it should be used in conjunction with other assessments to make informed decisions about the appropriate course of action.

Frequently asked questions