Fetal heart rate monitoring is a procedure used to evaluate the well-being of the baby in-utero by assessing the rate and rhythm of the fetal heartbeat. Unfortunately, in Kenya and most developing countries, this technology is rarely if ever used due to lack of medical equipments and supplies.

Successful fetal heart monitoring during labour could mean the difference between a well bouncing baby, lifetime debilitated baby with cerebral palsy or fetal demise.

In developing countries like Kenya, fetoscopes, a manual stethoscope-like instrument are used but they are only able to give the OB/GYN limited information at the time of assessment. If the condition of the baby changed 1 minute after the assessment, there is no way of telling.

External Fetal Heart Monitoring:

External fetal heart rate monitoring uses an external device to listen to or record the fetal heartbeat through the mother's abdomen. A Doppler/ultrasound device may also be used to check the fetal heart rate at regular intervals during labor. This method is reliable but may not be the safest.

Continuous electronic fetal heart monitoring may be used during labor and birth. This electronic monitoring is similar to ECG for the heart. An ultrasound transducer placed on the mother's abdomen conducts the sounds of the fetal heart to a computer device. These electronic fetal heart monitors are equipped with alarms to alert the nurse or the physician in case of fetal distress. The rate and pattern of the fetal heart are displayed on the computer screen and printed onto special graph paper, just like ECG/EKG

Internal Fetal Heart Monitoring:

Internal fetal heart rate monitoring is inserted by a physician transvaginally and uses an electronic transducer connected directly to the baby scalp. A wire detector is connected to the monitor. This type of internal monitoring is more accurate and consistent. It is more accurate than external fetal monitoring methods. Internal fetal monitoring may be used when external monitoring is inadequate, or closer surveillance is needed.

During labor, contractions are monitored along with the fetal heart rate. A pressure-sensitive device called a tocodynamometer is placed on the mother's abdomen over the area of strongest contractions to measure the length, and frequency of uterine contractions. Since the fetal heart rate and uterine contractions are recorded at the same time, effects of such contractions on the baby can be recorded in real time.

Variations of fetal heart rate before, during and after uterine contractions provides variable information such as: -

• Integrity of the cord: Is the cord safe? Wrapped around the neck or trapped between baby’s head and cervix opening?
• Biophysical profile (BPP)
• Effects of medications administered during labour to the baby
• Effects of labour inducing medications and narrow range between therapeutic and dangerous dose.
• Integrity of the placenta and many more.

Buying a Fetal Heart Monitor:

A fetal heart rate monitor is a MUST HAVE for any obstetrician/gynecologist. In developed countries, perinatal cerebral palsy is seen as a result of malpractice and in some cases, criminal negligence. A mother has 18 years to sue the hospital and hospital staff due to prenatal and perinatal avoidable conditions.

A brand new fetal monitor can be expensive especially in situations where a facility requires several for multiple patients. A factory refurbished or a used fetal heart monitor is a much cheaper alternative. Brand name fetal heart monitors like GE & Phillips even when gently used are cheaper, more reliable, longer lasting and more accurate than Chinese imitations.

For more information about options, testing and ordering fetal heart monitoring devices, contact us.

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