Internal Fetal Monitoring

________________________________________________________________________

KEY POINTS

• Internal monitoring uses a small wire put through your vagina and attached to your baby’s scalp to measure your baby's heart rate during labor. A different monitor may be used inside your uterus to measure contractions.
• The test shows how strong and frequent your contractions are, and how your baby is doing during labor. The test helps your provider know if you need medicines, oxygen, or other treatment to safely deliver your baby.

________________________________________________________________________

What is internal fetal monitoring?

Internal fetal monitoring is a way to measure your baby's heart rate during labor. Internal monitoring uses a small wire put through your vagina and attached to your baby’s scalp. A different monitor may be used inside your uterus to measure contractions.

When is it used?

Internal fetal monitoring may be done when you are in labor. Information about the baby's heart rate and how it changes with contractions helps your healthcare provider know how your baby is doing. This test also shows how strong and frequent your contractions are.

You may have internal monitoring if:

• Your provider wants to watch the baby's condition more closely.
• Your provider wants to measure the strength of your contractions.
• Your provider wants more information than an external monitor (monitor on your belly) can give.
• You have a high-risk pregnancy such as:
  • Being pregnant with more than 1 baby
  • Being older than 35
  • Having high blood pressure
• You have a health condition such as diabetes.
• You have been given medicine to start your contractions.

What happens during the procedure?

A small wire is inserted through your vagina and placed on the skin of the baby's scalp to record the baby's heart rate. You may also have a small tube (an intrauterine pressure catheter) inserted through your vagina into your uterus. The tube has a gauge attached to it that measures how strong and how fast your contractions are.

The results are seen as graphs on a video screen. The monitor may show problems that mean your baby is not getting enough oxygen. For example:

• Your baby's heart rate is too fast or too slow
• Your contractions are too frequent.

If the baby’s heart rate is not normal your healthcare provider may:

• Give you oxygen to breathe
• Change your position
• Give you IV fluids to increase low blood pressure
• Give you medicine to stop or slow your contractions or to lessen their strength
• Deliver the baby right away with forceps (an instrument used to grasp and hold your baby's head while your provider gently pulls the baby out) or vacuum extraction (a soft cup attached to your baby’s head with a suction pump to help your provider gently pull the baby through the birth canal)
• Deliver your baby by C-section, which is an operation that delivers your baby through a cut in your belly and uterus

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You or your baby may have infection or bleeding.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.