Pregnancy Symptoms: Electronic Fetal Heart Monitoring Part 3

How It Is Done

External monitoring can be done any time after 20 weeks of pregnancy. Internal monitoring is used only when you are in labor and your amniotic sac has broken. If internal monitoring is needed and your amniotic sac has not broken, your doctor may break the sac to begin the test. Sometimes a combination of internal and external monitoring is done by measuring your baby's heart rate with an internal sensor and measuring your contractions with an external sensor.

External monitoring

For external monitoring, you will usually lie on a table on your back or left side. Two belts with sensors attached will be placed around your belly. One belt holds the sensor that keeps track of your baby's heart rate, while the other measures the timing and strength of your uterine contractions. 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 that can indicate or print out a record of your baby's heart rate as well as the strength and duration of uterine contractions. The position of the heart rate monitor may be changed periodically to adjust to the movement of your baby.

For a nonstress test, the sensors are placed on your belly. You will 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 and compared to the record of movement or your contractions. This test usually lasts about 30 minutes.

For a contraction stress test, the sensors are placed on your belly. After about 20 minutes of monitoring, uterine contractions are started (induced). To start contractions, you may be instructed to stimulate your nipples or you may be given a medication called oxytocin (Pitocin) in a vein (intravenous, or IV). If oxytocin is given, it will be increased gradually until you have 3 contractions in 10 minutes. Changes in your baby's heart rate in response to your contractions are measured.

Internal monitoring

For internal monitoring, you will usually lie on a table on your back or left side. A thin wire (electrode) will be guided through your vagina and cervix and attached to your baby's scalp. A small tube is also inserted through your vagina to connect a device that monitors the contractions inside your uterus. 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 that can indicate or print out a record of your baby's heart rate as well as the strength and duration of your uterine contractions.

How It Feels

Lying on your back (or side) while you are being monitored may be uncomfortable or painful if you are having labor contractions. The belts holding the monitors in place may feel tight.

You may be able to change positions or move around more during internal electronic fetal heart monitoring than during external monitoring.

Placing the internal monitor into your uterus may be mildly uncomfortable.

Risks

You may have a cesarean delivery and not really need it if continuous electronic fetal heart monitoring shows that your baby is in distress when he or she is actually healthy.

If the machine is having technical problems, the machine may show that your baby is healthy when he or she is in distress. This is rare.

There is a slight risk of infection for your baby when internal monitoring is done.