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18-09-2024 Team Medicover woman-and-child

Written by Medicover Team and Medically Reviewed by Dr Manjusha Padamata

Fetal Heart Monitoring

Monitoring a baby's heartbeat during pregnancy and labor is really important for understanding how the baby is doing inside the mother's body. Monitoring the baby's heart helps doctors ensure the baby is healthy, spot any problems, and make safe choices about delivering the baby. This is a regular and essential part of prenatal care, especially later in the pregnancy and during labor.

What is Fetal Heart Monitoring?

Fetal heart monitoring is a process used to check a baby's heart rate before and during labor. It helps assess whether the baby is getting enough oxygen and whether there are any signs of stress.

The normal fetal heart rate is usually between 110 and 160 beats per minute, though this can vary based on the baby's movements or contractions.

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Why is Fetal Heart Monitoring Done?

Fetal heart monitoring is performed for several important reasons:

It helps doctors check on the baby's health during regular check-ups.
It's especially important for pregnancies that may have complications like gestational diabetes or high blood pressure.
The monitoring allows doctors to see how the baby is coping with contractions during labor.
It can help identify if the baby is in distress like not getting enough oxygen.
This monitoring is also during procedures like induced labor or epidural anaesthesia

Stages of Fetal Heart Monitoring

Fetal heart monitoring can be divided into different stages based on the period of pregnancy and labor. Here's a closer look at each stage:

Early Pregnancy

During the early stages of pregnancy, fetal heart monitoring is usually done using a Doppler ultrasound. This portable device uses sound waves to detect the baby's heartbeat. This stage occurs around 10-12 weeks of pregnancy.

Mid to Late Pregnancy

As the pregnancy progresses, expectant mothers will have regular check-ups that include listening to the baby's heartbeat. During these visits, doctors might use a more advanced type of ultrasound to get a clearer view of how the baby's heart is doing. This is important to make sure the baby is growing and developing properly.

Labor and Delivery

During labor and delivery, continuous fetal heart monitoring is usually performed. This can be done either externally or internally based on the situation. he main purpose of this is to check if the baby is doing okay and to spot any potential problems early on.

Types of Fetal Heart Monitoring

There are two main types of fetal heart monitoring:

1. External Monitoring (Non-Invasive)

A device called a Doppler ultrasound or a fetal monitor belt is placed on the mother's abdomen to detect and record the baby's heartbeat. It's commonly used during checkups or early labor.

2. Internal Monitoring (Invasive)

If more detailed data is needed, a small electrode is placed on the baby's scalp through the cervix. This is only done after the water has broken and is more accurate than external monitoring.

3. Intermittent Auscultation

The baby's heart rate is checked at regular intervals using a handheld Doppler or a stethoscope-like device called a fetoscope. It is commonly used during labor in low-risk pregnancies and allows more freedom of movement for the mother.

4. Continuous Electronic Fetal Monitoring

This involves continuous tracking of the fetal heart rate and uterine contractions using external or internal devices. It is often used in high-risk labour or when there are concerns about the baby's well-being.

When and How Fetal Heart Monitoring is Used

During pregnancy check-ups, doctors often use a small device called a Doppler to hear the baby's heartbeat.
In late pregnancy or high-risk cases, special tests called non-stress tests may be performed. These tests help doctors monitor the baby's heart rate to ensure everything is going well.
During labour, doctors may use continuous monitoring to see how the baby is doing in relation to contractions. This allows for real-time observation of the baby's response.

Based on your pregnancy and delivery plan, monitoring can be done at regular intervals or continuously.

Interpreting Fetal Heart Rate

Normal Heart Rate Range

For a healthy fetus, the heart rate typically beats between 110 -160 times per minute. It's normal for this rate to change based on how active the baby is or how far along the pregnancy is.

Variability, Acceleration and Deceleration

Variability refers to the changes in the baby's heart rate. These changes are a good sign, as they show that the baby's brain and heart are working well.
When the heart rate gives a brief increase, it's called an acceleration and it usually means the baby is doing well.
If the heart rate drops, it's referred to as a deceleration. This can be normal or a cause for concern, depending on when it happens during labor.

What Abnormal Heart Rates May Mean?

If someone's heart is beating too fast or too slow, or if there are unexpected heart rhythms, it could mean a few different things like:

Oxygen shortage
Umbilical cord issues
Infections
Placental problems

In these situations, doctors might take action such as providing oxygen to the mother, changing her position or even performing an emergency delivery to ensure everyone's safety.

Safety and Risks Associated with Fetal Heart Monitoring

External monitoring is completely safe and non-invasive. Whereas internal monitoring, which involves placing a small device inside the womb, is generally safe for most women but does come with some risks. These can include:

A small chance of getting an infection
Some discomfort or bleeding
Reduced ability to move around during labor, especially if monitoring is done continuously

Even with these risks, doctors always suggest regular monitoring, particularly if there are concerns about the baby's well-being during labor.

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Conclusion

Fetal heart monitoring is an important and simple way to check on your baby's health during pregnancy and birth. Whether it's done at your regular doctor appointments or continuously while you're in labour, this monitoring gives helpful information about how your baby is doing. If you have any questions or worries about how the monitoring works or about your baby's heart rate, don't hesitate to talk to your doctor. Your peace of mind is important!

Frequently Asked Questions

You can use a handheld Doppler device, usually from around 12 weeks. Always follow instructions and consult your doctor for guidance.

During routine prenatal visits, typically once a month early on, then more frequently in later trimesters. High-risk pregnancies may require more monitoring.

With a Doppler, usually by 10–12 weeks. An ultrasound can detect it as early as 6–7 weeks.

Sometimes, yes, usually after 18–20 weeks based on the baby's position and the mother's body type.

It's fast and rhythmic, like a galloping horse, usually between 110–160 beats per minute.