To put it simply, electronic fetal monitoring (EFM) is used to keep track of the fetal heart rate and the contractions of the expecting mother. Furthermore, fetal monitoring during labor can quickly show any potential issues and distress. While some experts suggest electronic fetal monitoring for high-risk pregnancies only, it’s not uncommon for various OB/GYN providers to use it as a general practice. If you are pregnant or looking to conceive, you can count on the professional preconception and obstetrics specialist in Florida. That said, keep on reading to learn more about electronic fetal monitoring.
What’s Electronic Fetal Monitoring?
To check fetal heart rate and mother’s contractions on the monitor, the doctor will likely use electronic fetal monitoring during labor. The progress of your baby is monitored in real time and continuously during the delivery.
The blood arteries that carry oxygenated blood to the infant are compressed during labor. In general, pregnant women should not worry about their babies’ oxygen levels dropping too low during labor. However, if your baby’s blood oxygen levels drop, their heart rate will fluctuate, which is precisely why fetal monitoring strips are used.
Your doctor will be able to spot any problems and take preventative measures if they keep an eye on fetal heart rate and contractions on the monitor. Even though it is extremely uncommon, fetal discomfort can occur when oxygen levels drop too low.
When a medical intervention, such as an epidural, is used to induce or facilitate labor, the most recent American College of Obstetricians and Gynecologists guidelines urge the use of electronic fetal monitoring strips. In addition, EFM is useful for high-risk pregnancies when:
- The mother suffers from existing health conditions such as diabetes, bleeding during pregnancy, preeclampsia, past C-sections, etc.
- The baby drops the stool during delivery, which points to distress.
- The baby is unusually small or shows congenital abnormalities.
Can EFM Be Used Before Labor?
Electronic fetal monitoring strips may be used to evaluate the well-being of the fetus during pregnancy, particularly following abdominal trauma. After being pregnant for 20 or more weeks, your doctor may suggest continuous monitoring for four to 24 hours if you have experienced trauma. Also, your doctor can use EFM to tell the difference between real and false labor by tracking contractions on the monitor.
The data from the devices is recorded on an external screen or paper log. The doctor or nurse will take the baseline fetal heart rate and periodically check the monitor. The fetal heart rate may fluctuate slightly during contractions, but that is entirely normal. Heart rate changes that may be indicative of an actual issue include:
- Above or below normal heart rate for a relatively long time period
- Heart rate slowing down untypically during contractions
Additionally, the EFM may be equipped with alarms to alert the delivery staff to any fluctuations in the fetal heart rate. As it develops inside the mother’s body, a healthy fetal heart rate typically ranges from 110 to 160 beats per minute. When the infant begins to move, it increases.
Different Types of EFM
The most common type of EFM is the external kind. A pair of measuring devices are fastened to the woman’s abdomen with elastic strips. To determine the fetal heart rate, an ultrasound machine is placed over the belly. With a pressure gauge on the upper stomach, the doctor can track how often the contractions occur. However, it is not a reliable method of gauging the strength of contractions.
External EFM does not necessitate any specific post-care. Unless your doctor tells you otherwise, you should return to your regular diet and daily routine.
Doctors rarely rely on internal fetal monitoring. Although more invasive, this method is useful when movement prevents a steady heart rate from being recorded. The baby’s heart rate is monitored using a cable that is threaded through the vagina and attached to the scalp. A uterine catheter may be inserted to monitor contractions. Internal EFM is considered only when the water has already broken and more precise monitoring is required.
The baby’s electrode site will be checked for infection, bruises, or cuts when internal EFM is complete. It may be necessary to use an antiseptic to clean the area. It is possible that your doctor will provide you with different or additional post-procedure instructions based on your unique condition.
You will be confined to your bed or chair if you use external EFM. For patients requiring external EFM, several institutions provide wireless telemetry monitoring. On the other hand, internal EFM necessitates complete bed rest.
Potential Risks of EFM
In terms of potential EFM risks, we have to mention the following:
- Stress-inducing but false labor alarms
- False fetal distress issues that then warrant unnecessary C-section or forceps/vacuum delivery
- Limitations to the woman’s movement range
- In case internal EFM is necessary, there are additional risks involved:
- Developing an infection
- Potential damage to baby’s head
- Potentially transmitting disease from the mother to the child
Furthermore, the uterine catheter can, albeit rarely:
- Tangle up with the umbilical cord
- Cause damage to the placenta and/or uterus
Not all abnormal EFM readings indicate imminent risk to the unborn child. Your healthcare provider may suggest a position shift to help increase blood flow. The doctor may recommend a C-section or a vaginal delivery using forceps/vacuum devices if there is a specific pattern to a fetal heart rate that actually points to a problem after delivery has begun.
If you notice that your child’s heart rate abruptly stops, you should not worry. The device on your abdomen probably moved and is no longer picking up the heart rate. Simply have the nurse make the necessary adjustments.
Your doctor will perform fetal monitoring during labor in case there are any complications. There is no need to be concerned if you find yourself alone at some point. Central monitoring allows doctors and nurses to keep an eye on fetal heart rate without having to be near you.
It is possible that EFM can both reassure you that everything is fine with your baby and alert you to issues that necessitate an emergency C-section. However, most women with low-risk pregnancies who don’t plan on giving medication-assisted birth do not require electronic fetal monitoring. You should consult your doctor about the usual procedures for EFM as you prepare for the delivery. Don’t hesitate to consult us and share all of your questions and concerns with us at University Park OB/GYN. You can count on our experts and top-notch equipment for all of your pregnancy and gynecological needs.