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How to Read a Fetal Monitor

Fetal monitor is a piece of medical equipment used to measure the heart rate of an unborn child while in utero, most commonly while the mother is in labor or undergoing a procedure that has risks associated with the baby. To many, the lines that appear on the monitoring strip read like a foreign language that only healthcare professionals can decipher. However, with a little practice, anyone can learn to speak the language.

Placing the Leads: There are two leads or sensors that make up the external fetal monitors. One of these round sensors monitors the contractions of the mother's uterus, and the other measures the fetal heart rate, or FHR. External fetal monitors are applied by the nurse, or another healthcare provider.

1.Internal fetal monitors are placed by a physician or nurse practitioner. A lead is placed on the baby's scalp through the mother's cervix, and a catheter is placed inside the uterus to measure the pressure of its contractions.

2.This particular FHR has a baseline of about 140 BPM

Finding the Baselines: The baseline of the FHR is the heart rate that is most commonly seen throughout. The best way to find it is to draw a line that the FHR returns to after every peak and trough. The baseline for the uterine contractions is the level of tone the muscle returns to after every contraction.

3.Early decelerations on a fetal heart monitor strip

What It All Means: You will notice the fetal heart rate does not appear as a steady line on the monitor strip. This is called variability. Every once in a while, usually during contractions, increases or decreases in the heart rate may occur. The following are three classifications of this occurrence:

Accelerations: This is when the FHR seems to rise slightly during the contractions. This is always a good sign when looking at a fetal monitor.

Early Decelerations: This is when the FHR decreases briefly just before a contraction occurs, or mirrors the contraction. This simply means the baby's head is being compressed in the mother's pelvic cavity. Early Decelerations are usually a good sign.

Variable Decelerations: Sometimes, the baby's heart rate will drop slightly either before or after the contraction. This could be good or bad. It could simply mean head compression (which is fine), or it could indicate compression of the umbilical cord (not good).

Late Decelerations: This is when the FHR begins to decrease on the later half of the contraction, and seems to stay down for a long time. This is never seen as a good sign in fetal monitoring because it can indicate uteroplacental insufficiency, or the breakdown of the baby's life support.