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High-Risk Pregnancy

Fetal Monitoring

What is fetal monitoring?

During late pregnancy and during labor, your physician may want to monitor the fetal heart rate and other functions. Fetal heart rate monitoring by the non-stress testing (the "NST" - see below) is a method of checking the rate and rhythm of the fetal heartbeat over a short period of time, usually 20 to 30 minutes. The average fetal heart rate is usually between 110 and 160 beats per minute. The fetal heart rate may change as the fetus responds to conditions in the uterus, especially during labor when changes are expected. An abnormal fetal heart rate or pattern may mean that the fetus is not getting enough oxygen or there are other problems. An abnormal pattern also may mean that an emergency or cesarean delivery is needed.

How is fetal monitoring performed?

Using a fetoscope (a type of stethoscope) to listen to the fetal heartbeat is the most basic type of fetal heart rate assessment. Another type of assessment is with a hand held Doppler device. This is often used during prenatal visits to count the fetal heart rate. During labor, continuous electronic fetal monitoring is often used. Although the specific details of each procedure vary slightly, generally, electronic fetal monitoring follows this process:

  • Gel is applied to the mother's abdomen to act as a medium for the heart rate monitor.

  • The heart rate monitor is attached to the abdomen with straps and transmits the fetal heartbeat to a recorder. The fetal heart rate is displayed on a screen and printed onto special paper.

  • Another monitor checks for contractions. This is called a tocodynamometer and it is placed over the top of the uterus with a belt.

  • During labor, internal fetal monitoring may be necessary for a more accurate reading of the fetal heart rate. Your bag of waters (amniotic fluid) must be broken and your cervix must be partially dilated to use internal monitoring. Internal fetal monitoring involves inserting an electrode through the dilated cervix and attaching the electrode to the scalp of the fetus, called a fetal scalp electrode.

What are the risks and benefits of fetal monitoring?

Risks Benefits
Fetal monitoring is widely used. There are no known risks to using the fetoscope, Doppler, or external monitoring. There may be a slight risk of infection with internal monitoring. The scalp electrode may also cause a mark or small cut on the baby's head, but this usually heals quickly. Fetal monitoring may help with possible recognition of problems in the fetus. Other testing or delivery may be necessary.



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Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.


Lucile Packard Children's Hospital
725 Welch Road
Palo Alto, California 94304
(650) 497-8000


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