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Electronic fetal heart monitoring is done during pregnancy, labor, and
delivery. It keeps track of the heart rate of your baby (fetus). It also checks the strength and length of the contractions of your
uterus are. Your baby's heart rate is a good way to tell
if your baby is doing well or may have some problems.
types of monitoring can be done: external and internal.
You may have
external monitoring at different times during your pregnancy. Sometimes it's done
External monitoring can be done by listening to your
baby's heartbeat with a special stethoscope. More often, it is
done using two flat devices (sensors). They are held in place with elastic belts on your
belly. One sensor uses reflected sound waves (ultrasound) to keep track of
your baby's heart rate. The other sensor measures how long your contractions last.
The sensors are connected to a machine that records the details. Your
baby's heartbeat may be heard as a beeping sound or printed out on a chart. How often you have contractions and how long they last may be printed on a chart.
External monitoring is used for a
nonstress test. This test records your baby's heart rate
while your baby is moving and not moving. A nonstress test may be done with
fetal ultrasound to check the amount of amniotic fluid.
External monitoring is also done for a
contraction stress test. This test records changes in your
baby's heart rate when you have contractions. It may be done to check
on your baby's health if your baby does not move enough during a nonstress
test. It may help predict whether your baby can handle the stress of labor and
Sometimes external monitoring is done remotely. This is called telemetry. It allows you to be checked without being hooked up to a machine.
At some hospitals, the sensors can send the details about your baby's heart
rate and your contractions to a remote monitor. This monitor is usually at a nurse's
station. Using a remote monitor allows you to walk around freely.
Internal monitoring is done during labor. It can be
done only after your
cervix has dilated to at least 2 centimeters (cm). Your
amniotic sac must have ruptured as well. After it is started, it is continued until delivery.
For internal monitoring, a sensor
is strapped to your thigh. A thin wire (electrode) from the sensor
is put through your cervix into your uterus. The electrode is
then attached to your baby's scalp. Your baby's heartbeat may be heard as a
beeping sound or printed out on a chart.
A small tube
that measures contractions may be placed in your uterus next to your
baby. The strength and timing of your contractions is often printed
out on a chart.
Internal monitoring is more exact than external
monitoring for keeping track of your baby's heart rate and your
This type of monitoring is done to:
This type of monitoring is
You may be asked to eat a meal shortly
before you have a nonstress test. When you digest food, it often causes a baby to move more.
If you smoke, you will be asked to stop smoking for 2
hours before external monitoring. Smoking causes a baby to be less active.
External monitoring can be done at any
time after 20 weeks of pregnancy. Internal monitoring is used only when you are
in labor and your amniotic sac has broken. If it is needed and
your amniotic sac has not broken, your doctor may break the sac to start the
Sometimes both types of monitoring will be done at the same time. Your baby's heart rate may be checked with an internal sensor, and your
contractions may be checked with an external sensor.
For external monitoring, you
may lie on your back or left side. Two belts with sensors
attached will be placed around your belly. Gel may be applied to provide good
contact between the heart rate sensors and your skin. The sensors are attached
with wires to a recording device. This device can show or print out a record of
your baby's heart rate and the strength and length of contractions. The position of the heart rate monitor may be changed
now and then as your baby moves.
nonstress test, you may be asked to push
a button on the machine every time your baby moves or you have a contraction.
Your baby's heart rate is recorded. Then it's compared to the record of movement or
your contractions. This test usually lasts about 30 minutes.
For internal monitoring, you
will usually lie on your back or left side. A thin wire (electrode)
will be put through your cervix and attached to your baby's
scalp. A small tube is also put in your uterus. The tube connects to a device
that monitors your contractions.
A belt is placed around your
upper leg to keep the monitor in place. The electrode and the tube are attached
with wires to a recording device. It can show or print out a record of
your baby's heart rate and the strength and length of your contractions.
Lying on your back (or side) may not be comfortable if you are having contractions. The belts that hold the monitors in place may feel tight.
You may be able to change position or move around more during internal
monitoring than during external monitoring.
You may have some discomfort when the internal monitor is put into your uterus.
Electronic fetal monitoring
may be linked to an increase in cesarean deliveries. It may also be linked to the use of a vacuum
or forceps during delivery.footnote 1
There is a
slight risk of infection for your baby when internal monitoring is done.
Electronic fetal heart monitoring is done during pregnancy, labor, and
delivery. It keeps track of the heart rate of your baby (fetus). It also checks the
strength and length of the contractions of your
uterus. The results are usually ready right away.
Your baby's heart rate is 110 to 160 beats per
Your baby's heart rate increases when he
or she moves and when your uterus contracts.
Your baby's heart rate drops during a contraction but
quickly goes back to normal after the contraction is over.
Uterine contractions during labor are strong and
Your baby's heart rate is less than 110 beats per
Your baby's heart rate is more than 160 beats per
nonstress test, your baby's heart rate does not
increase by 15 beats per minute or it drops far below its baseline rate after he or she moves.
Uterine contractions are weak or irregular during
You may not be able to have the test, or the results may not be helpful, if:
American College of Obstetricians and Gynecologists (2009). Intrapartum fetal heart rate monitoring: Nomenclature, Interpretation, and General Management Principles. ACOG Practice Bulletin No. 106. Obstetrics and Gynecology, 114(1): 192–202.
Other Works Consulted
American College of Obstetricians and Gynecologists (2010). Management of intrapartum fetal heart rate tracings. ACOG Practice Bulletin No. 116. Obstetrics and Gynecology, 116(5): 1232–1240.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
ByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerWilliam Gilbert, MD - Maternal and Fetal Medicine
Current as ofAugust 11, 2015
Current as of:
August 11, 2015
Sarah Marshall, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & William Gilbert, MD - Maternal and Fetal Medicine
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