FETAL MONITORING
Presented by
Debashruti Bera
1st year MSc Nursing
CON,AIIMS Mangalagiri
Learning Objectives
Definition
Methods of Fetal Monitoring
• Intermittent Fetal monitoring
• Handheld Doppler
• Fetoscope
• Continuous Fetal monitoring
• Non invasive methods
• Invasive methods
Summary
Conclusion
Bibliography
INTRODUCTIO
N
Fetal monitoring is an essential aspect of prenatal care and
labor management, used to assess the health and well-being
of the fetus. It involves monitoring the fetal heart rate (FHR),
the pattern of uterine contractions, and sometimes fetal
movements. These methods help detect signs of fetal
distress or other complications, allowing healthcare
providers to intervene promptly when necessary.
DEFINITION
Fetal monitoring is a
procedure that
measures the health
of a fetus during
pregnancy and labor
by checking the
baby's heart rate
and other functions.
METHODS OF FETAL MONITORING
Intermittent
Fetal
Fetal monitoring Non-invasive
Monitoring method
Continuous
Fetal
monitoring
Invasive
method
Intermittent fetal monitoring
Handheld Doppler Fetoscope
Advantages of Intermittent Fetal
Monitoring
Easily available equipment
Allows the woman to move freely and
change positions
Effective in identifying issues in low-
risk cases without the need for
continuous monitoring.
Disadvantages of Intermittent Fetal
Monitoring
Provides very limited data
Not ideal for high-risk pregnancies
Sometimes may delay diagnosis
Continuous Fetal
Monitoring
DFMC
CTG
Non-
invasive NST
method
CST
Continuous
Fetal BPP
Monitoring
FSE
Invasive
method
IUPC
Daily fetal movement count (DFMC)
Daily fetal Movement Count is a method
used by expectant mothers to monitor
their baby's well-being during
pregnancy.
It involves the mother tracking the
number of times her baby moves within
one hour period after breakfast, lunch
and dinner.
Cardiff Count to Ten method
Indications
Reduced Fetal Movement
Changes in Movement Pattern
Preterm Labor
Gestational Diabetes
Hypertensive Disorders (e.g., Pre-eclampsia)
Intrauterine Growth Restriction (IUGR)
Cardiotocography
Non Stress Test (NST)
• Non-stress test is a graphic recording of fetal heart
rate acceleration in response to fetal movement as
sign of fetal health.
• Variables that must be evaluated in NST are:
o Baseline fetal heart rate (normal being 120-160
beats per minute)
o Variability: Normal is 5 to 25 beats per minute
o Presence or absence of accelerations
o Presence or absence of decelerations
Indications
o All high risk pregnancies, eg. diabetes, hypertension
o Decrease or loss of fetal movements
o Post datism
o Fetal kick count less than 10 in 12 hours
o Unexplained fetal loss in previous pregnancy
Contraction Stress Test (CST)
• A Contraction Stress Test
(CST) is a procedure used to
evaluate how well the fetus
will tolerate labor by
assessing the fetal heart rate
response to uterine
contractions.
Indications
When NST results are inconclusive or non-reactive, a
CST can help determine fetal well-being.
Suspected fetal compromise
To assess fetal well-being in advance aged pregnancies
with increased risks.
Post-term pregnancies
Biophysical Profile (BPP)
The Biophysical
Profile (BPP) is a
prenatal test
designed to assess
the health and well-
being of the fetus
during the later
stages of
pregnancy. It
combines
ultrasound imaging
with a Non-Stress
Components of the Biophysical Profile
Fetal Heart Rate
Fetal Breathing Movements
Fetal Movements
Fetal Tone
Amniotic Fluid Index(AFI)
Invasive method of fetal monitoring
Invasive
method of
fetal
monitoring
Intrauterine
Fetal Scalp Pressure
Electrode Catheter
(IUPC)
Fetal Scalp Electrode
• It measures the fetal heart
rate directly by attaching an
electrode to the fetal scalp
or other presenting part.
Intrauterine Pressure Catheter (IUPC)
It measures the strength, frequency, and duration of
uterine contractions.
Advantages of Continuous Fetal
Monitoring
1.Provides continuous, detailed data, enabling healthcare
providers to detect and respond quickly to signs of fetal
distress.
2.Essential in cases of complications like preeclampsia,
gestational diabetes, preterm labor, or fetal growth
restriction.
3.Helps doctors to determine the need for cesarean section,
instrumental delivery, or changes in labor management.
Disadvantages of Continuous Fetal
Monitoring
1.The equipment often restricts the woman’s movement,
limiting the use of positions or walking.
2.Invasive monitoring increases the risk of infection,
bleeding, or discomfort.
3.False positives from non-specific abnormal FHR patterns
can lead to unnecessary interventions.
Assignment
Write the role of a nurse in invasive fetal monitoring.
Evaluation
• What are the components of BPP?
Fetal Heart Rate
Fetal Breathing Movements
Fetal Movements
Fetal Tone
Amniotic Fluid Index(AFI)
Evaluation
• Identify the procedure
shown in the picture?
• Intermittent fetal
monitoring using handheld
dropler.
Conclusion
• Fetal monitoring is a vital tool for ensuring fetal well-being
during pregnancy and labor. The choice between
intermittent and continuous methods depends on the risk
profile, maternal preferences, and clinical circumstances.
While intermittent monitoring is ideal for low-risk cases,
continuous monitoring may be necessary in high-risk
pregnancies or when complications arise.
BIBLIOGRAPHY
1. Marshall J, Raynor M. Myles textbook for midwives.
Edinburgh: ELSEVIER;2024.
2. Kumari N, Sharma S. A textbook of midwifery/obstetrics
and gynecology (OBG) nursing-I. Jalandhar City: S. VIKAS
AND COMPANY;2024.
3. Massey A. Comprehensive midwifery/ obstetrics and
gynecology (OBG) nursing- I. Jalandhar City: S. VIKAS AND
COMPANY;2024.
4. Sharma J B. Midwifery and obstetrical nursing. New Delhi:
ARYA PUBLICATION COMPANY;2024.
5. Dutta D C, Textbook of obstetrics, New Delhi. JAYPEE. 10 th
Edition, 2023
