Fetal heart rate monitoring

The average fetal heart rate is between 110 and 160 beats per minute. It can vary by 5 to 25 beats per minute. The fetal heart rate may change as your baby responds to conditions in your uterus. An abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems.

1. Monitoring And Recording Fetal Heart Rate Presented By: Ms.Neetu A grahari BSc (N) 4 th year Era college of nursing Guided By: Dr.AnjalatchiMuthukumaran Vice principal Era college of nursing

2. INTRODUCTION The average fetal heart rate is between 110 and 160 beats per minute . It can vary by 5 to 25 beats per minute. The fetal heart rate may change as your baby responds to conditions in your uterus. An abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems.

3. DEFINITION Fetal heart rate monitoring is the measuring of the featl heart rate during the labor by using a special instrument Normal fetal heart rate :- average of 140 beats /min

4. TYPES OF FETAL HEART RATE MONITORING Intermittent auscultation Electronic fetal monitoring

5. INTERMITTENT AUSCULTATION It is a method of listening to the fetal heartbeatb for about 60 seconds by using a fetal stethoscope

6. ELECTRONIC FETAL MONITORING Electronic fetal monitoring is done by using the Electronic monitor that is used to continuously measure the fetal heart rate

7. INDICATIONS Pregnancy complications Reasons for Fetal Heart Rate Monitoring The doctor is more likely to use fetal heart rate monitoring when your pregnancy is high-risk. You may need fetal heart rate monitoring when: You have diabetes. You have  high blood pressure . You’re taking medicine for  preterm labor . Your baby isn’t growing or developing normally.

8. Preterm labour

9. Previous cesarean

10. Overweight mother

11. Multiple fetus

12. High blood pressure

13. CONTRAINDICATIONS Discomfort Infection Scratching in baby scalp

14. Preparation of patients Identify the patients details Check the doctors order Check any complication/precautions/restriction etc Get informed consent Prepare the patient physically and psychological support

15. Preparation of the environment Arrange the area to check the procedure Get ready for comfortable bed Provide the privacy Provide the conversation the patient be relax while doing the procedure Get adequate light and ventilation Arrange all articles near to the patient Make the necessary record

16. Procedure Fetal Heart Rate Monitoring Procedure Fetal heart rate monitoring could happen in your doctor’s office or at the hospital. The procedure will depend on what type of monitoring you’ll have. External fetal heart rate monitoring procedure Your doctor will ask you to undress and lie down on an exam table or labor bed. You’ll get clear gel on your belly. Your doctor will press a gadget called Doppler transducer to your belly and move it around. You’ll hear the sound of your baby’s heartbeat. If your doctor wants to measure the heartbeat continuously, they’ll use a wide belt to hold the transducer in place. Your doctor will record the fetal heart rate. You may see it on a computer screen.

17. Internal fetal heart rate monitoring procedure You’ll be asked to undress and lie down. You’ll put your  feet  and legs in supports, like you’re getting a vaginal exam. The doctor will check to see if your cervix is dilated. If your water hasn’t broken, the doctor may break it. The doctor will feel for your baby’s head. The doctor will put a thin tube (catheter) with a small wire at the end into your  vagina . The doctor will put the wire on your baby’s scalp and remove the catheter. Once it’s connected to a cable, the wire will record your baby’s heartbeat until a doctor removes it or your baby is born.

18. METHOD OF MONITORING External:- external fetal heart rate monitoring uses a device to listen to or record the fetal heartbeat through the mothers abdomen. A fetoscope is a most basic type of monitor

19. Internal monitoring Internal monitoring:  Once your water breaks and your cervix opens to prepare for birth, the doctor can run a wire called an electrode through it and into your womb. The wire attaches to your baby’s head and connects to a monitor. This gives a better reading than listening to your baby’s heartbeat from the outside.

20. Fetal Heart Rate Monitoring Results A healthy baby’s heart usually beats 110-160 times a minute in the womb. It speeds up when the baby moves. Signs of possible problems include: Heart beats slower than 110 beats a minute Heart beats faster than 160 beats a minute A heartbeat pattern that isn’t normal The heartbeat doesn’t go up when the baby moves or during contractions Lack of a normal heartbeat doesn’t always mean something is wrong with your baby. But it can be a sign that the baby isn’t getting enough oxygen. Your results also may be less accurate if: You’re  obese . You or your baby is in the wrong position. You have too much  amniotic fluid .

21. Fetal Heart Rate Monitoring Risks External monitoring isn’t risky. It doesn’t hurt or use radiation. If your doctor uses a belt, it might be a little uncomfortable. It also might mean you have to stay in bed during labor. Internal monitoring risks include: Slight discomfort Infection Bruising or scratching your baby’s scalp

22. Abnormal Fetal Heart Rate Treatments If your baby’s heart rate isn't what it should be, the doctor may try: Changing your positions to move the baby Giving you fluids through an IV Having you  breathe   extra oxygen Relaxing your uterus with medicine to slow contractions Giving you other  drugs If these steps don’t return your baby’s heart rate to normal, you may need to deliver them right away. If your cervix is completely open, the doctor may use a tool called forceps or a special vacuum to help you push the baby out. Otherwise, you’ll have the baby by  cesarean section .

23. SUMMARY In the topic fetal heart rate monitoring and recording I have discussed about introduction, definition, types, indication, contraindications, method of external fetal heart rate monitoring