What is internal fetal monitoring?

Internal fetal monitoring is a way to measure your baby’s heart rate during labor. Internal monitoring uses a small wire put through your vagina and attached to your baby’s scalp.

When is it used?

Internal fetal monitoring may be done when you are in labor. Information about the baby’s heart rate and how it changes with contractions helps your healthcare provider know how your baby is doing. This test also shows how strong and frequent your contractions are.

You may have internal monitoring if:

• Your provider wants to watch the baby’s condition more closely.
• Your provider wants to measure the strength of your contractions.
• Your provider wants more accurate information than an external monitor (monitor on your belly) can give.
• You have a high-risk pregnancy (for example, you are pregnant with more than 1 baby, you are older than 35, or you have high blood pressure).
• You have a health condition, such as diabetes.
• You have been given medicine to start your contractions.

What happens during the procedure?

A small wire is inserted through your vagina and placed on the skin of the baby’s scalp to record the baby’s heart rate. You may also have a small tube called a catheter inserted through your vagina into your uterus. The catheter has a gauge attached to it that measures how strong and how fast your contractions are.

The results are viewed as graphs on a video screen. The monitor may show problems that mean your baby is not getting enough oxygen. For example:

• Your baby’s heart rate is too fast or too slow
• Your contractions are too frequent.

If the baby’s heart rate is not normal your healthcare provider may:

• Give you oxygen to breathe.
• Change your position.
• Give you IV fluids to increase low blood pressure
• Give you medicine to stop or slow your contractions or to lessen their strength.
• Deliver the baby right away with forceps (an instrument used to grasp and hold your baby’s head while your provider pulls the baby out) or vacuum extraction (a soft cup attached to your baby’s head with a suction pump to help your provider gently pull the baby through the birth canal).
• Deliver your baby by C-section (an operation that delivers your baby through a cut in your belly and uterus).

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You or your baby may have infection or bleeding.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.