Fetal heart rate monitoring is used during labor to evaluate any distress the fetus is undergoing prior to delivery — and to prevent oxygen deprivation resulting in a brain damaged baby. The monitoring consists of assessment of the rate and rhythm of the heartbeat of the fetus.
The average fetal heart rate is between 110 and 160 beats each minute, and the variation may range from 5 to 25 beats per minute. This is normal. However, the fetal heart rate may vary widely in response to abnormal conditions in the uterus. If the fetus is not getting enough oxygen, the heart rate might vary widely or have an abnormal rhythm or rate.
The physician or healthcare provider must monitor and recognize abnormal patterns in fetal heart rate, and must be able to respond quickly to signs of fetal distress. Minutes matter, as oxygen deprivation to the fetus can result in permanent brain damage to the newborn child.
There are two ways to monitor heart rate in the fetus. The external method involves using a fetoscope – like a stethoscope – to listen the baby’s heartbeat through the mother’s abdomen. Sometimes a handheld ultrasound device is used. This device is often used during prenatal visits, and may be used during labor. However, there are electronic fetal monitors, with ultrasound transducers placed upon the mother’s abdomen to continuously monitor the baby’s heart rate during labor. The rate and pattern are printed onto graph paper and displayed upon a computer screen. This monitor is continuous and should not be ignored during labor and birth, as it is the first indicator of fetal distress.
An invasive internal fetal monitor is often used during labor, and this involves the placement of a wire electrode on the fetal scalp through the opening of the cervix. The electrode is then connected to a monitor. This type of monitor is commonly used if there are specific concerns during labor. It provides a more consistent reading than the external monitor.
At the same time, the mother’s contractions are monitored with a “tocodynamometer.” This is a device placed on the abdomen, and measures frequency and strength of uterine contractions during labor. There are also internal monitors to measure the pressure of uterine contractions.
The healthcare provider has a responsibility to watch the monitoring devices, and if they ignore or misread signs of fetal distress, they may be held liable for any disability or death due to failure to deliver in cases of fetal distress. During birth, the physician also has a responsibility to monitor any problems with the umbilical cord, which provides oxygen rich blood to the fetus. Injuries from lack of oxygen may include brain damage, cerebral palsy, paralysis or death.
If your pregnancy has resulted in death or disability of your child, contact Passen & Powell at 312-527-4500 to discuss whether an investigation is warranted.