Fetal Monitoring During Labor and Delivery

Fetal Monitoring During Labor and Delivery

1) Periodic auscultation - per minute basis

2) FHR - baseline without contraction should be 120-160 bpm. Baseline variability is dependent on fetal sleep wake states, medications, hypoxia. Marked acceleration (more than 180 bpm) may be related to prematurity, maternal fever, hypoxia, fetal infection, and drugs.

3) External Monitoring:

a. External Mode

• Tocotransducer - pressure-sensing device applied to maternal abdomen to monitor frequency and duration of contraction
• Ultrasound Transducer - continous monitor of FHR, which can be interpreted in relation to contraction
• Phonotransducer and abdominal electrodes - fetal electrocardioram

b. Internal Mode

• Spiral electrode - applied to fetal presenting part; provides continous measurement of FHR, baseline variability, and periodic changes
• Intrauterine catheter - pressure transducer inserted beyond presenting part; measures frequency, duration, and intensity of contractions

4) Fetal scalp sampling - a small sample of fetal blood is taken from a punctured wound made into the fetal scalp to test for the presence of fetal acidosis.
- Laboratory analysis of fetal pH is done; Normal value ranges from 7.25 to 7.35. A reported value of 7.20 or below means fetal acidosis.

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