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Continuous vs Intermittent Fetal Monitoring: Which is Better?
Updated on
- Written by Amelia Smith, MFA
Medically reviewed by
Brittany Ferri, Ph.D.
When it comes to the well-being of your unborn child, choosing the right fetal monitoring method is crucial. Making the wrong choice in fetal monitoring can have serious consequences. Thus, you want to ensure their safety and receive accurate information during this precious time. Continuous and intermittent monitoring each has their own benefits and considerations.
In this comprehensive comparative analysis, we aim to provide you with valuable insight and help you make an informed decision. Understand the distinctions between continuous and intermittent fetal monitoring to make the best decision for you and your baby.
We will also delve into the pros and cons of continuous and intermittent fetal monitoring. We will explore their effectiveness, comfort levels, potential risks, and impact on labor interventions.
By the end of this piece, you will have a clear understanding of which monitoring approach aligns with your preferences and needs, empowering you to make the best decision for your baby’s health.
Continuous Vs. Intermittent Fetal Monitoring: Which Is Better?
Continuous and intermittent monitoring are two approaches used to assess the well-being of the baby during pregnancy and labor. Continuous monitoring involves the continuous tracking of the baby’s heart rate and other vital signs using specialized equipment. Contrastingly, intermittent monitoring involves periodic assessments of the baby’s heartbeat.
The main difference lies in the frequency of monitoring and the level of mobility for the mother during labor. Continuous monitoring provides a continuous record of the baby’s heart rate, while intermittent monitoring offers more freedom of movement for the mother. The choice between the two methods depends on various factors like the risk level of the pregnancy and the progress of labor.
What Is Fetal Monitoring?
Fetal monitoring[1] is a critical process used to evaluate the well-being of a developing fetus during pregnancy and labor, starting as early as with a 16 weeks pregnant woman. By tracking specific parameters, healthcare providers gain crucial insight into the baby’s health. They can also detect any potential abnormalities. There are two primary types of fetal monitoring: electronic fetal monitoring (EFM) and intermittent monitoring.
Electronic Fetal Monitoring (EFM)
Electronic Fetal Monitoring (EFM) is a widely used method during labor to assess the well-being of the baby. It involves the utilization of an electronic fetal monitor, which is a device that records the fetal heart rate and uterine contractions externally.
This non-invasive monitoring technique provides continuous information about the baby’s heart rate patterns and the timing and strength of contractions. EFM helps healthcare providers identify any signs of distress or abnormalities in the baby’s heart rate. This allows for prompt intervention if necessary.
Intermittent Monitoring
Intermittent Monitoring is an invasive technique used to get more precise and direct measurements during labor. It involves the insertion of a fetal scalp electrode or an intrauterine pressure catheter.
A fetal scalp electrode is a small electrode attached to the baby’s scalp. It allows for accurate monitoring of the fetal heart rate. An intrauterine pressure catheter measures the strength and frequency of uterine contractions from within the uterus.
This method provides more detailed information about the baby’s well-being and the progress of labor. However, it carries a slightly higher risk of infection due to the invasive nature of the procedure.
Benefits Of Fetal Monitoring
- Fetal monitoring helps identify potential signs of distress or complications, ensuring timely intervention.
- Continuous monitoring, such as the continuous electronic fetal monitoring (CEFM), offers a continuous and comprehensive view of the fetal heart rate[2] and contractions.
Limitations Of Fetal Monitoring
- Continuous monitoring, including CEFM, may lead to an increased rate of interventions, such as cesarean deliveries.
- It can limit the mother’s mobility during labor. This will affect her comfort and birthing experience.
How Does It Work?
Fetal heart rate monitoring or Electronic fetal monitoring[3] (EFM) is a commonly used method to assess the baby’s heart rate and uterine contractions during labor. Here’s how the procedure works:
- Placement of Sensors: To begin, healthcare providers attach external sensors to the mother’s abdomen. These sensors consist of a transducer for monitoring the baby’s heart rate and a tocometer to measure uterine contractions.
- Monitoring Baby’s Heart Rate: The transducer emits and receives ultrasound waves. This allows it to detect and record the baby’s heart rate. A monitor displays the information and a speaker transmits the baby’s heart rate.
- Assessing Uterine Contractions: Simultaneously, the tocometer measures the frequency, duration, and intensity of the mother’s uterine contractions. It also displays this data on a monitor.
- Interpretation and Analysis: Healthcare providers analyze the patterns of the baby’s heart rate in relation to the uterine contractions. They look for specific patterns and changes that may indicate distress or other concerns.
Which Is Better: Continuous Fetal Monitoring Or Intermittent Auscultation?
Continuous fetal monitoring and intermittent auscultation/monitoring are two methods used to monitor the baby’s well-being during labor. Let’s compare and contrast these approaches along with their pros and cons.
Continuous Fetal Monitoring
Pros
Continuous electronic monitoring[4] provides a continuous view of the baby’s heart rate. It also allows for immediate detection of any concerning changes. It is particularly beneficial in high-risk pregnancies and situations where close monitoring is essential for patient safety.
Cons
Continuous monitoring is associated with an increased rate of interventions. Some of these interventions are instrumental vaginal births and cesarean deliveries. It may limit the mother’s mobility and comfort during labor, affecting the birthing experience.
Intermittent Auscultation
Pros
Intermittent auscultation[5] offers greater freedom of movement for the mother during labor and is less invasive compared to continuous monitoring. It allows for a more natural birthing experience and has a lower risk of interventions.
Cons
Intermittent monitoring may miss subtle changes in the baby’s heart rate between assessments. This can potentially lead to delayed detection of distress. It requires skilled healthcare providers to interpret the fetal heart sounds accurately.
According to the American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin on fetal heart monitoring, the choice between continuous monitoring and intermittent auscultation should be based on the specific circumstances of each pregnancy. The choice of investigation mostly depends on the risk associated with the pregnancy.
What Kind Of Monitoring Will You Need?
The type of monitoring you may need during pregnancy and labor depends on several factors:
- Risk Factors: The presence of specific risk factors may warrant more intensive and continuous monitoring.
- Maternal Health: The overall health of the mother plays a role in determining the type of monitoring needed. Certain medical conditions, such as high blood pressure or diabetes, may require closer observation.
- Progress of Labor: The progression of labor and the presence of any complications or deviations from the norm may necessitate continuous monitoring.
Remember to maintain a healthy diet during pregnancy. Whole grains, lean meat, fruits and vegetables are examples of good foods to eat when pregnant during the first trimester. Coconut water for pregnant women is also a great way for them to stay hydrated.
Can Intermittent Work Instead Of Continuous Fetal Monitoring?
The decision to use intermittent monitoring instead of continuous monitoring depends on a number of factors. Such factors include the mother’s and baby’s overall health, and the progress of labor.
In a low risk pregnancy where there are no concerns, intermittent monitoring can be a suitable option. It allows the mother more freedom of movement and a more natural birthing experience.
However, in certain high-risk pregnancies or situations, closer and continuous monitoring is necessary. Then, healthcare providers may use continuous monitoring.
What If A Doctor Detects A Problem?
When a problem is detected during fetal monitoring, healthcare providers take effective steps to ensure the well-being of the baby and the mother. Healthcare providers may take the following key actions:
- Evaluation: The healthcare provider carefully assesses the nature and severity of the problem. They do this by analyzing the fetal heart rate patterns and considering other relevant factors.
- Intervention: Depending on the specific situation, appropriate interventions may be initiated. The mother’s position may be changed or oxygen therapy may be considered along with medication adjustments, including iron supplements for pregnancy.
- Further Monitoring: Continuous monitoring may be implemented to keep a close watch on the baby’s response to interventions. It is also done to assess the effectiveness of the measures taken.
- Consultation: In complex cases or situations where specialized expertise is required, the healthcare provider may consult with other healthcare professionals, such as obstetricians, neonatologists, or fetal medicine specialists, to ensure comprehensive and appropriate management.
Conclusion
Fetal monitoring plays a vital role in assessing the well-being of the baby during pregnancy and labor. The choice between the two methods depends on various factors, including risk factors, maternal health, and the progress of labor.
Healthcare providers carefully evaluate these factors, taking into account relevant opinions such as Ritual Prenatal reviews, to determine the most appropriate monitoring approach.
Effective interventions and timely responses to detected problems ensure patient safety and optimize outcomes. Ultimately, the goal is to provide individualized care that promotes the health and well-being of both the mother and the baby.
Frequently Asked Questions
Fetal monitoring involves tracking the baby’s heart rate and other vital signs during pregnancy and labor to assess their well-being.
The two main types of fetal monitoring are continuous electronic monitoring and intermittent auscultation.
Doctors typically recommend continuous monitoring for high-risk pregnancies or when complications arise during labor.
Continuous monitoring allows for real-time detection of changes in the baby’s heart rate and immediate intervention if needed.
The choice depends on factors like risk factors, maternal health, and the progress of labor.
Fetal monitoring helps detect signs of distress that may indicate potential risks for the baby’s health, including cerebral palsy.
Fetal monitoring is considered safe, but it can sometimes lead to false alarms or increased stress for the mother.
Continuous monitoring provides a continuous record of the baby’s heart rate, while intermittent monitoring involves periodically listening to the baby’s heartbeat.
+ 5 sources
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- Kauffmann, T. and Silberman, M. (2023). Fetal Monitoring. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK589699/.
- Yang, X., Zhang, K. and He, J. (2021). Application and Clinical Analysis of Remote Fetal Heart Rate Monitoring Platform in Continuous Fetal Heart Rate Monitoring Images. [online] 2021, pp.1–11. doi:https://doi.org/10.1155/2021/5517692.
- Goddard, R. (2001). Electronic fetal monitoring. [online] 322(7300), pp.1436–1437. doi:https://doi.org/10.1136/bmj.322.7300.1436.
- Crawford, A.Z., Dexter, Johnstone, E.D. and Alexander (2017). Women’s experiences of continuous fetal monitoring – a mixed-methods systematic review. [online] 96(12), pp.1404–1413. doi:https://doi.org/10.1111/aogs.13231.
- Blix, E., Maude, R., Hals, E., Sezer Kisa, Karlsen, E., Nohr, E.A., Ank de Jonge, Lindgren, H., Downe, S., Liv Merete Reinar, Maralyn Foureur, Aase and Kaasen, A. (2019). Intermittent auscultation fetal monitoring during labour: A systematic scoping review to identify methods, effects, and accuracy. [online] 14(7), pp.e0219573–e0219573. doi:https://doi.org/10.1371/journal.pone.0219573.
Written by:
Amelia Smith, MFA
Medically reviewed by:
Medically reviewed by:
