At the end of pregnancy and especially during your delivery, the baby is monitored with fetal monitoring or cardiotocograph. All you need to know about fetal monitoring.

External fetal monitoring or external cardiotocograph is an examination of the third trimester of pregnancy that simultaneously records the baby’s heart rate and the contractions of the uterus. It allows to know if the heart rate of the fetus is good and if it does not suffer during uterine contractions.

In practice: two bands placed around the mother’s abdomen, equipped with an ultrasound device, record uterine contractions as well as the baby’s heart rate (electrocardiogram). Reading the cardiotocographic tracing makes it possible to assess the well-being of the fetus.

It is an examination carried out in the event of maternal or fetal pathology: gestational diabetes, threat of premature delivery (PAD), intrauterine growth retardation (IUGR) … The frequency of monitoring depends on the pathology: there may be a monitoring twice a month as well as several times a day (especially in the case of a hospitalized mother). If the baby is in pain, an extraction is performed, most often by cesarean section.

Fetal monitoring is often performed systematically at the end of pregnancy.

The monitoring is left in place for about 30 minutes for monitoring during pregnancy.

During childbirth, the analysis of the fetal heartbeat allows you to see how the fetus supports uterine contractions, which alter the flow of blood in the placenta and reduce the oxygen supply. The baby’s heart normally beats between 120 and 160 beats per minute. Monitoring makes it possible to detect a possible malaise of the baby, often linked to a lack of oxygen (fetal asphyxia).

If anomalies are detected, the midwife asks the mother-to-be to change position first, as abnormalities in the cord may explain this fetal suffering. Since uterine contractions that are too strong or too long can also cause fetal discomfort, drugs are given to the mother to normalize the heart rate of the fetus if this is the case. If the abnormalities persist, after additional examinations, it may be decided to use forceps or suction cups or even to perform a cesarean section to get the baby out quickly.

If abnormalities in the fetal heart rate are detected (decrease or increase in baseline heart rate, prolonged decelerations, etc.), the medical team present can use internal sensors inserted into the uterus to specify the abnormalities: fetal pulse oximetry, fetal electrocardiogram. A small drop of blood can also be taken from the skin of the baby’s skull to see if it lacks oxygen: this is the pH scalp technique.

Fetal monitoring is an essential part of fetal monitoring.

Thanks to the cardiotocograph, a decrease in perinatal mortality was recorded. Continuous recording is recommended by the French National College of Gynecologists-Obstetricians (CNGOF).

Changes in heart rate and persistent changes are difficult to detect by intermittent monitoring. Continuous recording is more accurate than discontinuous monitoring for detection of fetal oxygen deficiency. It halves the risk of neonatal seizures. However, continuous monitoring during childbirth is associated with an increased risk of cesarean section, use of forceps or suction cups, because it has low specificity: the abnormalities detected are not necessarily a sign of fetal distress but can testify to a physiological adaptation.

Some professionals also believe that continuous monitoring is anxiety-provoking for parents. Indeed, it can be nerve-wracking to watch every trace and hear warning beeps (fetal monitoring is very sensitive. But midwives know when to intervene. Try not to keep your eyes on the monitoring. As you are. do not know how to read the plot, you may panic when all is well!