women s health issues
Labor
Fetal monitoring
Soon after the woman is admitted to the hospital, the doctor or another health care practitioner listens to the fetus’s heartbeat periodically using a type of stethoscope (fetoscope) or a handheld Doppler ultrasound device or continuously using electronic fetal heart monitoring. Practitioners monitor the fetus's heart to determine whether the fetus's heart rate is normal and thus whether the fetus is in Fetal Distress . Certain abnormal changes in the fetus’s heart rate during contractions can indicate that the fetus is not receiving enough oxygen. The fetus’s heart rate can be monitored in the following ways: Externally:An ultrasound device (which transmits and receives ultrasound waves) is attached to the woman’s abdomen. Or a fetoscope is placed on the woman's abdomen at regular intervals. Internally:An electrode (a small round sensor attached to a wire) is inserted through the woman’s vagina and attached to the fetus’s scalp. The internal approach is typically used when problems during labor appear likely or when signals detected by the external device cannot be recorded. This approach can be used only after the membranes that contain the fetus have ruptured (described as "the water breaks"). Use of an external ultrasound device or internal electrode to monitor the fetus's heart rate is called electronic fetal monitoring. Electronic monitoring is used to continuously monitor the contractions of the uterus. It is used for virtually all high-risk pregnancies and, in many practices, for all pregnancies. In a Overview of High-Risk Pregnancy , electronic monitoring is sometimes used as part of a nonstress test, in which the fetus’s heart rate is monitored as the fetus lies still and as it moves. If the heart rate does not speed up as expected on two occasions within 20 minutes of when the fetus moves, the heart rate is described as nonreactive or nonreassuring. Then an ultrasound biophysical profile may be done to check on the fetus's well-being. For anultrasound biophysical profile,ultrasonography is used to produce images of the fetus in real time, and the fetus is observed. After 30 minutes, doctors assign a score of 0 or 2 to the following: Results of the nonstress test (reactive or nonreactive) Amount of amniotic fluid Presence or absence of a period of rhythmic breathing Presence or absence of at least three clearly visible movements of the fetus Muscle tone of the fetus, indicated by stretching, then flexing the fingers, a limb, or the trunk A score of up to 10 is possible. Based on the result, doctors may allow labor to continue or may do a cesarean delivery immediately. the heart rate of the fetus is monitored periodically with a stethoscope or an ultrasound device or continuously using electronic monitoring. Monitoring the fetus’s heart rate is the easiest way to determine whether the fetus is receiving enough oxygen. Abnormalities in the heart rate (too fast or too slow) and variations in the heart rate (over time and in response to contractions) may indicate that the fetus is in distress ( Fetal Distress ). The heart rate of the woman is also monitored periodically. During the second stage of labor,the fetus’s heart rate is monitored after every contraction or, if electronic monitoring is used, continuously. The woman’s heart rate and blood pressure are monitored regularly. 