The Role of Fetal Monitoring in Labor and Delivery

Fetal monitoring during labour and delivery is of utmost importance, especially when it
comes to the safety of both mother and baby. The main aim is to track the fetal heart rate and detect any signs of distress that might require medical attention. With advances in medical technology, monitoring techniques have evolved to give precise data in real-time, thus enhancing the ability of healthcare providers to manage labour efficiently. Here, in this blog, we shall explore the various methods of fetal monitoring, the significance of these techniques, and the role they play in safeguarding the mother and baby during labour.

What is Fetal Monitoring?

Fetal monitoring is the process of measuring the heart rate and rhythm of the fetus
during pregnancy, labour and delivery. It gives valuable insights into the baby’s health. This ensures that the fetus does not experience any type of distress and receives enough
oxygen.

Fetal monitoring during pregnancy is carried out periodically to check for any
abnormalities. However, during labour, continuous or intermittent monitoring is used from time to time. This is done to keep the baby’s heart rate in a safe zone. The process helps healthcare providers identify any particular issue in the early stages and take quick, effective measures when necessary.

Why is Fetal Monitoring Important?

Fetal monitoring during labour plays an important role in making sure the mother and baby are safe during labour. The fetal heart rate monitor is used by healthcare providers to detect changes in the baby’s condition, such as heart rate decelerations or abnormalities, which could indicate distress. If the fetal heart rate shows signs of irregularities, such as sudden drop or prolonged slowing, immediate action will be required to avoid oxygen deprivation or other health risks.

Reasons Why Fetal Monitoring is Important

Detecting Fetal Distress: Fetal monitoring during pregnancy helps detect early signs
of distress in the fetus. If the baby’s heart rate drips outside the normal range (usually
between 110 and 160 beats per minute), this indicates that there is a lack of oxygen,
umbilical cord problems or placental issues. Identifying the problems in the early stages,
doctors will have to take the necessary steps to protect the baby’s health.

Ensuring Adequate Oxygen Supply: During labour, the contractions of the uterus can
reduce the amount of oxygen reaching the fetus. Thus, fetal monitoring during pregnancy becomes important to check if the baby is coping well with labour stress and if the oxygen level is sufficient.

Guiding Medical Interventions: In cases where fetal monitoring reveals signs of
distress, doctors will decide on the necessary action, such as performing a cesarean section (C-section) or using tools like forceps or vacuum extraction to expedite delivery. These interventions are important in situations where the baby needs to be delivered as soon as possible to avoid further complications.

Monitoring Uterine Activity: Fetal monitoring during labour is not just about the
baby's heart rate. It also tracks uterine contractions, allowing healthcare providers to assess the strength and frequency of contractions. This information is necessary for determining how the baby is handling the labour process and if any adjustments are required in terms of pain management at the time of delivery.

Types of Fetal Monitoring

There are two primary methods of fetal monitoring: external and internal. Both methods are for the same purpose, but their approach and level of detail differs.

1. External Fetal Monitoring

External monitoring is the most common and least invasive method used during labour. It involves placing two sensors on the mother’s abdomen to measure the baby’s heart rate and the strength of uterine contractions.

Ultrasound Transducer: This device uses sound waves to detect the fetal heart rate and
sends the data to a monitor. It is a combination of a contraction sensor (tocodynamometer), which tracks the timing and duration of uterine contractions.

Advantages of External Monitoring: The external method is non-invasive and provides
continuous monitoring of the baby’s heart rate. It can be used throughout labor and is
particularly useful in cases where the mother is experiencing a normal, low-risk pregnancy.

Limitations: External fetal monitoring can sometimes be less accurate if the baby moves
around a lot during labour, or if the mother has a high body mass index (BMI). In these
cases, the sensors will find it difficult to detect the heart rate clearly. This further leads to
inaccuracies in the data provided.

2. Internal Fetal Monitoring

In cases where external monitoring is not providing clear results, internal fetal heart rate
monitoring may be used. This method is invasive in nature, providing better results.

How It Works: Internal monitoring involves inserting a thin wire (called a fetal scalp
electrode) through the mother’s cervix and attaching it to the baby’s scalp. This electorate directly measures the baby’s heart rate and transmits the data to the monitor.

Advantages of Internal Monitoring: Internal monitoring gives more accurate results,
especially when external monitoring is not possible due to potential factors like maternal
obesity or excessive fetal movement.

Limitations: As the internal fetal heart rate monitor is invasive, internal fetal monitoring can be used only if the mother’s water is broken and the cervix is dilated. Furthermore, it carries risk of infection or injury in the baby’s scalp.

The Role of the Fetal Monitor

The fetal monitor plays an important role in checking the safety of both mother and baby during delivery. Checking the baby’s heart rate and the mother’s contractions, the monitor will alert the healthcare professional about any distress. Accordingly, the professional will be able to intervene quickly and prevent complications. 

Fetal Monitor Role: The primary role of the fetal monitor is to detect any abnormalities
in the fetal heart rate that may indicate distress. If the fetal heart rate monitor shows irregular patterns, immediate medical interventions need to be made to protect the baby.

Fetal Monitor Importance: The importance of the fetal monitor cannot be ignored.
Without this device, healthcare professionals won’t be able to track the baby’s condition
during labour, making it difficult to identify and respond to potential issues in a timely
manner.

Advancements in Fetal Monitoring

With technological advancements, portable ECG monitors are now available, allowing for
fetal monitoring even in settings outside traditional hospitals. These devices give accurate real-time data on the baby’s heart rate and mother’s contractions. It enables healthcare providers to check the labour process and make informed accurate decisions accordingly. A portable ECG machine is useful in high-risk pregnancies where monitoring will be done continuously, thus giving the flexibility to monitor fetal health in diverse environments.

FAQ

What happens if the monitor shows my baby is in distress?

If the monitor shows signs of distress, your doctor will take the necessary action
immediately. Here, taking quick action means giving the mother extra oxygen, changing
position or doing an emergency C-section if necessary. The goal is to keep the baby safe in case of a crisis.

How accurate is fetal monitoring?

Fetal monitoring is very reliable, but like all medical tools, it’s not 100% accurate all the time. At times, movements can affect the readings, which is why doctors use other means of assessment to check their well-being.

Are portable monitors as good as the ones used in hospitals?

Portable ECG monitors can be a great tool, especially for home or remote monitoring, but they might not give as much detail as hospital-grade equipment. They are, however, very useful for high-risk pregnancies where regular checkups are needed.

Do I have to be monitored the whole time during labor?

Not always. Some women need continuous fetal monitoring, especially if the pregnancy is complicated. But intermittent monitoring is done. Here, the baby's heart rate is checked at regular intervals.