What is Internal Fetal Monitoring During Labor and Delivery?

Internal Fetal Monitoring
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Question: What is Internal Fetal Monitoring During Labor and Delivery?


Internal fetal monitoring is used for high-risk births or during a normal birth where the birth team is having trouble keeping the baby on the monitor or the baby's reaction doesn't look great on the less accurate form of external fetal monitoring (EFM).

With internal fetal monitoring the mother's bag of waters must be broken.

If it has not broken on it's own then an amniotomy will be performed to break the water. A fetal scalp electrode is placed by screwing a tiny sire into the top layers of the baby's scalp, then relaying the baby's heart rate to the fetal monitor. This is more accurate because it does not use ultrasound.

At the same time an intrauterine pressure catheter (IUPC) can also be placed inside the uterus. It goes between the uterine wall and the baby. This also allows the midwife or doctor to know the exact force from the contractions, rather than a simple graphical representation given by external monitoring. This is very useful in the case of induction.

Internal monitoring can also prevent an unnecessary cesarean for fetal distress if it shows the baby is healthy, compared to the less accurate external monitoring. Though there are risks associated with the internal monitor:

  • Risk of infection for mom and baby
  • Restricts movement of the mother
  • Reduction in movement can cause more pain

More Information: Other Interventions in Labor

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