GRP 14 Fetal Monitoring

FETAL MONITORING:
 Fetal monitoring is a way for physician to monitor unborn infant’s heartbeat and to ensure that there are
no any medical complications. The process is done under the facilitation of special designed biomedical
equipment known as CTG machine.
 In pregnancy and during labor, your healthcare provider will want to check the health of the unborn
baby (fetus). This is done by checking the baby’s heart rate and other functions. Fetal monitoring is
a very common procedure.
METHOD USED TO MONITOR FETAL HEART RATE.
1. AUSCULTATION OF THE FETAL HEART

 This can be done through the use of stethoscope or Doppler probe done every 15 minutes after a
uterine contraction during the first stage of labor.
 It is termed as periodically to the fetal heartbeat.
2. ELECTRONIC FETAL MONITORING
Is the process in which instruments are used to continuously record the heartbeat rate of the fetus and
contractions of the woman’s uterus during labor.
The process can be done by an instrument called Cardiotography machine (CTG)
Electronic fetal monitoring can be done internally or externally or both.
 External electronic fetal monitoring.
With this method a pair of belts is wrapped around the mother’s abdomen, where by one belt uses Doppler
to detect the fetal heart rate. The other belt measure the length of contractions and the time between them.
 Internal electronic fetal monitoring.
Here, an electrode is placed on the part of fetus closest to the cervix, usually the scalp. The device record
the heart rate of the fetus
Uterine contractions also may be monitored with special tube called an intrauterine pressure catheter that
is inserted through the vagina into your uterus. Internal monitoring can be used only after the membranes
of the amniotic sac have ruptured (after broken).
 Fetal heart rate monitoring is used to check the rate and rhythm of the heartbeats. It looks for any
increases or decreases in the baby’s heartbeat. It also checks how much the baby’s heart rate
changes. The average fetal heart rate is between 110 and 160 beats per minute. The fetal heart rate may
change as the baby responds to conditions in the uterus. An abnormal fetal heart rate or pattern may
mean that the baby is not getting enough oxygen or there are other problems. An abnormal pattern also
may mean that an emergency cesarean section (C-section) delivery is needed.
 Fetal monitoring may also help show problems in the baby during late pregnancy and labor. It can
show if other testing or a C-section may be needed.
PRINCIPLE OF OPERATION.
Fetal monitors detect fetal heart rate externally by using an ultrasound transducer to transmit and receive
ultrasonic wave; the frequency (or Doppler) shift of the reflected signal is proportional to the velocity of
the reflecting structure-in this case, the fetal heart. A transducer contains one or more piezoelectric
elements that convert an electrical signal into ultrasonic energy that can be transmitted into tissues.
When this ultrasonic energy is reflected back from the tissues, the transducer converts it to an electrical
signal that can be used to create a waveform for display and recording and an audible fetal heart rate
(sound created by the frequency shift of the ultrasonic signal).
 Before anything the provider will put gel on belly, this helps to send sound waves from belly to the
computer.
 The provider puts a device called an ultrasound probe (transducer) on belly. It’s attached to belly with
straps. This device sends the fetal heartbeat to a recorder.
 The provider may put another device over the top of belly with a belt. This is called an external to
dynamometer. It can record the patterns of contractions.
 The fetal heart rate from the processing unit is displayed on a screen. It may also be printed on special
paper.
 In some cases, you may need internal fetal monitoring for a more accurate reading of the fetal
heart rate. This can only be done if your bag of waters (amniotic sac) is broken and your cervix is
partly open (dilated). The provider puts a small wire called a fetal scalp electrode through the open
cervix. It’s attached to the baby’s scalp. The electrode is attached to a wire. The wire sends
information about your baby’s heartbeat to a computer.
PROBLEMS AND SOLUTIONS ON TROUBLESHOOTING THE CTG MACHINE.
S/N PROBLEM TROUBLESHOOTING SOLUTION

1 Signal ambiguity Ensure the FHR monitor is tracking the fetal, not the
maternal, heart rate
2 Inadequate FHR tracing, poor Check that the monitors are providing useful data
communication, lack of clinical
context
3 Lack of situational awareness, failure  Maintain situational awareness
to address nursing concerns,  Acknowledge and respond to other care giver’s
reluctance to initiate the chain of concerns
command
4 Failure of power outlet Measure the power outlet if not responding move to
another power outlet or room
5 Short circuit in the fetal monitor Eye check inside the fetal monitor
6 Device is not responding at all Eye check the circuit body or wire connection in the
device, replace if necessary
REFERENCE:
https://www.who.int/medical_devises/en/indexhtml
https://www.mdedge.com/obgyn/article/108593/obstetrics/10-tips-overcoming-common-challanges-
intrapartum-fetal-monitoring

GRP 14 Fetal Monitoring

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FETAL MONITORING:

METHOD USED TO MONITOR FETAL HEART RATE.

1. AUSCULTATION OF THE FETAL HEART

2. ELECTRONIC FETAL MONITORING

The process can be done by an instrument called Cardiotography machine (CTG)

Electronic fetal monitoring can be done internally or externally or both.

 External electronic fetal monitoring.

S/N PROBLEM TROUBLESHOOTING SOLUTION

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