Fetal Monitoring

What is Fetal Monitoring

Monitoring your developing baby (fetus) before birth can identify potential problems for you and your baby. Fetal monitoring can:

  • Help prevent serious problems from developing.
  • Guide health care providers in how best to care for your unborn baby.
  • Check your unborn baby’s overall health.

The amount of monitoring and the specific tests that will be done will vary. It will depend on whether your pregnancy is considered to be low or high risk. For example, you may need certain tests if you have a medical problem that can put your unborn baby at risk.

Health care providers use several techniques and tests to monitor your baby before birth. No single test is perfectly accurate, and you may need to follow up with your health care provider if there are any concerns.

Fetal movement counts

When you are past 20 weeks of pregnancy, you may feel your baby move. As your baby gets bigger, these movements are easier to feel. A fetal movement count is when you count the number of movements (kicks, flutters, swishes, rolls, or jabs) over a specific period of time. You record the number and report it to your health care provider. This is often recommended in high-risk pregnancies, but it is good for every pregnant woman to do. Your health care provider may ask you to start counting fetal movements at 28 weeks of pregnancy.

Non-stress test

The non-stress test:

  • Evaluates fetal heartbeat:
    • While your baby is at rest.
    • While your baby is moving.
  • Is often done as part of a set of tests called the biophysical profile.
  • May show signs that it is time for your baby to be delivered.

The heart rate in a healthy baby will speed up when the baby moves or kicks. The heart rate will decrease at rest, and the peaks or accelerations of the heart rate will be lower.

If the test brings up any questions or concerns, you may need to have more testing. This test may be done if your pregnancy goes past your due date. It is also commonly done in high-risk pregnancies beginning at 32 weeks.

Biophysical profile

The biophysical profile is a set of tests that are done to find out how well the baby is doing. It includes the non-stress test along with imaging tests that use sound waves (ultrasound) to create images of your baby. In a biophysical profile, the following tests are done and scored:

  • Fetal heartbeat.
  • Fetal breathing.
  • Fetal movements.
  • Fetal muscle tone.
  • Amount of amniotic fluid.

Each test gets a score of either 2 (normal) or 0 (abnormal). The scores are then added together for a total score. A low score may mean that you and your baby need additional monitoring or special care. Sometimes your health care provider may recommend that you deliver early. This test is usually done after 32 weeks of pregnancy. It can be done sooner, if needed.

Contraction stress test

A contraction stress test monitors the heart rate of your baby during contractions. The test checks to see how your baby will tolerate the stress of labor. Health care providers use this test to further evaluate your baby when other tests, such as the biophysical profile, have shown that there may be a problem. This test may be done:

  • Any time you are in labor.
  • Between weeks 32 and 34 of your pregnancy.
  • Later, if necessary.

Modified biophysical profile

A modified biophysical profile is a two-part test. You will have:

  • An ultrasound exam, to check how much fluid is surrounding your baby inside of your womb (amniotic fluid).
  • A non-stress test, to check your baby’s heart rate.

The results will determine whether a full biophysical profile may be needed. This test is usually done late in your final 3 months (third trimester) of pregnancy.

Umbilical artery Doppler velocimetry

Umbilical artery Doppler velocimetry uses sound waves to measure the flow of blood between you and your baby. This test:

  • Measures the amount of blood flow through the cord that attaches your baby to your womb (umbilical cord).
  • Measures the speed of the blood flow.

You likely only need this test to check your baby’s condition if you have a high-risk pregnancy.

All types of monitoring aim to protect your health and that of your baby. The best way to have a healthy pregnancy and a healthy baby is to learn as much as you can about your pregnancy and to work closely with all your health care providers.

You may have tests during pregnancy to make sure that your developing baby (fetus) is healthy. These tests are called fetal monitoring. Umbilical artery Doppler velocimetry is one type of fetal monitoring. In this test, sound waves are used to measure the flow of blood between you and your baby.

The test measures the amount of blood that flows through the cord that attaches your baby to your womb (umbilical cord). It also measures the speed of the blood flow.

If your baby is smaller than normal, you may have this test to check for a condition that causes babies to grow at a rate that is slower than normal (intrauterine growth restriction, or IUGR). You may also need this test to monitor your baby’s health if you have a high-risk pregnancy.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.

What are the risks?

This test poses no risks to you or your baby.

What happens before the procedure?

  • Ask your health care provider about changing or stopping your regular medicines. Do nottake medicines that may increase or decrease the baby’s heart rate or movements.
  • Eat a full meal at least 2 hours before the test.

What happens during the procedure?

  • You will recline or lie on your back for this test.
  • A technician will put clear gel on your abdomen and then gently roll a handheld device (transducer) across your abdomen. This will not be painful. The gel helps the transducer produce clear images.
  • The transducer will project sound waves into your womb. The sound waves will be used to measure the speed of blood flowing through your umbilical artery. A moving image of the artery will be displayed on a computer screen.

What happens after the procedure?

You may go home and resume your usual activities unless directed otherwise by your health care provider.

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