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Internal Fetal Monitoring

What is internal fetal monitoring?

Internal fetal monitoring is a way to measure the baby's heart rate and the mother's contractions during labor. Instruments used for the measurements are put into the mother's uterus (womb). One instrument is connected directly to the baby's scalp. The measurements are displayed as graphs on a screen.

Information about the baby's heart rate and how it changes with contractions helps your healthcare provider know how the baby is doing. This test also shows how strong and frequent your contractions are.

Another type of fetal monitoring is external. It uses instruments placed on the mother’s belly instead of inside the uterus. Internal and external monitors record the same information, but internal monitoring is more accurate.

When is it used?

Your healthcare provider may use internal monitoring if:

  • Your provider wants to watch the baby's condition more closely.
  • Your provider wants to measure the strength of your contractions.
  • The external monitor is not recording accurately.
  • You have a high-risk pregnancy.
  • You have an illness, such as diabetes or high blood pressure.
  • You are given the drug oxytocin, which helps stimulate contractions.

When is it not used?

The membrane and fluid surrounding the baby (often called the bag of water) must be broken to put the instruments into the uterus. For this reason there are times when your healthcare provider will not use internal monitoring. You will not have internal monitoring if:

  • Your placenta is covering the opening to the uterus (a condition called placenta previa).
  • The baby is too high in the uterus and breaking the bag of waters could be dangerous.
  • You have a herpes infection. Using an internal monitor could increase the chance of spreading the infection to the baby.

What happens during the procedure?

The instruments used are a fetal scalp electrode and an intrauterine pressure catheter.

  • The electrode is a small wire. It is placed into the uterus and directly on the skin of the baby's scalp to record the baby's heart rate.
  • The catheter is a narrow, flexible tube inserted through the vagina and cervix into the uterus. A pressure gauge attached to the catheter measures the strength and frequency of contractions.

What happens if the fetal heart rate is not normal?

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

  • Give you oxygen to breathe.
  • Change your position.
  • Start intravenous (IV) fluids.
  • Give medicine to stop or slow the contractions or to lessen their strength.
  • Deliver the baby right away with forceps or vacuum extraction.
  • Deliver the baby by cesarean section (C-section).

What are the benefits of this procedure?

Fetal monitoring allows your healthcare provider to check the baby's response to contractions and labor. If the baby is not doing well, steps may be taken to help the baby.

What are the risks associated with this procedure?

The following possible complications from this test are rare:

  • The electrode may cause an infection on the baby's scalp.
  • Improper placement of the electrode may injure the baby.
  • The catheter put into the uterus may cause bleeding if it goes through the placenta or the uterine wall. Or it may cause an infection in the uterus.
Developed by RelayHealth.
Published by RelayHealth.
Last modified: 2010-12-28
Last reviewed: 2010-12-01
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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