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Monitor of fetal heart rate electronic manufacturing PCB assembly
Monitor of fetal heart rate electronic manufacturing PCB assembly
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  • Monitor of fetal heart rate PCBA turnkey assembly Manufacturing
    This method uses a thin wire (electrode) put on your baby’s scalp. The wire runs from the baby through your cervix. It is connected to the monitor. This method gives better readings because things like movement don’t affect it. But it can only be done if the fluid-filled sac that surrounds the baby during pregnancy (amniotic sac) has broken and the cervix is opened. Your provider may use internal monitoring when external monitoring is not giving a good reading. Or your provider may use this method to watch your baby more closely during labor.

    During labor, your healthcare provider will watch your uterine contractions and your baby’s heart rate. Your provider will note how often you are having contractions and how long each lasts. Because the fetal heart rate and contractions are recorded at the same time, these results can be looked at together and compared.

    Your provider may check the pressure inside your uterus while doing internal fetal heart monitoring. To do this, he or she will put a thin tube (catheter) through your cervix and into your uterus. The catheter will send uterine pressure readings to a monitor.

    Why might I need fetal heart monitoring?

    Fetal heart rate monitoring is especially helpful if you have a high-risk pregnancy. Your pregnancy is high risk if you have diabetes or high blood pressure. It is also high risk if your baby is not developing or growing as it should.

    Fetal heart rate monitoring may be used to check how preterm labor medicines are affecting your baby. These are medicines are used to help keep labor from starting too early.

    Fetal heart rate monitoring may be used in other tests, including:

    Nonstress test. This measures the fetal heart rate as your baby moves.
    Contraction stress test. This measures fetal heart rate along with uterine contractions. Contractions are started with medicine or other methods.
    A biophysical profile (BPP). This test combines a nonstress test with ultrasound.
    Things that may affect the fetal heart rate during labor:

    Uterine contractions
    Pain medicines or anesthesia given to you during labor
    Tests done during labor
    Pushing during the second stage of labor
    Your healthcare provider may have other reasons to use fetal heart rate monitoring.

    What are the risks of fetal heart monitoring?

    Radiation is not used for this test. The transducer usually causes no discomfort.

    You may find the elastic belts that hold the transducers in place slightly uncomfortable. These can be readjusted as needed.

    You must lie still during some types of fetal heart rate monitoring. You may need to stay in bed during labor.

    With internal monitoring, you may have some slight discomfort when the electrode is put in your uterus.

    Risks of internal monitoring include infection and bruising of your baby’s scalp or other body part.

    Note: You should not have internal fetal heart rate monitoring if you are HIV positive. This is because you may pass the infection on to your baby.

    You may have other risks depending on your specific health condition. Be sure to talk with your provider about any concerns you have before the procedure.

    Certain things may make the results of fetal heart rate monitoring less accurate. These include:

    Obesity of the mother
    Position of the baby or mother
    Too much amniotic fluid (polyhydramnios)
    Cervix is not dilated or the amniotic sac is not broken. Both of these need to happen to do internal monitoring
    How do I get ready for fetal heart monitoring?

    Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
    You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
    The consent form for fetal heart monitoring may be included as part of the general consent for labor and birth.
    Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, or anesthesia.
    If fetal heart rate monitoring is done along with another monitoring test, you may be asked to eat a meal before the test. This can help make your baby more active.
    The amniotic sac must be broken and your cervix must be dilated several centimeters before the internal device can be put in place.
    Follow any other instructions your provider gives you to get ready.
    What happens during fetal heart monitoring?

    You may have fetal heart rate monitoring in your healthcare provider's office or as part of a hospital stay. The way the test is done may vary depending on your condition and your healthcare provider's practices.

    Late decelerations associated with preservation of beat-to beat variability

    These decelerations appear to be mediated by arterial chemo receptors in mild hypoxia.
    When the level of oxygen in the fetal blood is below a pO2 of 15-20 mm Hg chemoreceptors are triggered causing reflex alpha adrenergic stimulation which constricts blood vessels in nonvital peripheral areas such as the arms and legs to divert more blood flow to vital organs such as the heart and brain. Constriction of peripheral blood vessels leads to hypertension.
    The hypertension stimulates a baroreceptor mediated vagal response that slows the heart rate. [20] .
    Late decelerations associated with no variability (where loss of variability has not been caused by drug administration)

    If the supply of oxygen continues to be limited (hypoxia) , the peripheral tissues cannot completely break down glucose and instead convert it to lactic acid. Significant levels of acid in the blood (acidemia) may suppress the fetal nervous system which becomes evident as decreased variability.
    As acidosis develops the brain stem reflexes become blunted and direct myocardial depression causes shallow decelerations [20,22].
    If myocardial depression is severe enough, lates may be absent all together [22].
    Etiologies of Late Decelerations

    Excessive uterine contractions, maternal hypotension, or maternal hypoxemia.
    Reduced placental exchange as in hypertensive disorders, diabetes, IUGR, abruption.
    Management of Late Decelerations

    These maneuvers are primarily intended to alleviate "reflex" lates.

    Place patient on side [23,24]
    Discontinue oxytocin.
    Correct any hypotension
    IV hydration.
    If decelerations are associated with tachysystole consider terbutaline 0.25 mg SC [26,27]
    Administer O2 by tight face mask [25, 40]
    If late decelerations persist for more than 30 minutes despite the above maneuvers, fetal scalp pH is indicated.
    Scalp pH > 7.25 is reassuring, pH 7.2-7.25 may be repeated in 30 minutes.
    Deliver for pH < 7.2 or minimal baseline variability with late or prolonged decelerations and inability to obtain fetal scalp pH [28,29]
    The observation of recurrent late decelerations with minimal or absent variability should lead to consideration of expeditious delivery unless the abnormal results are believed to be the result of a reversible maternal condition such as diabetic ketoacidosis or pneumonia with hypoxemia.

    Variable Decelerations




    Vagally mediated through chemoreceptors or baroreceptors.
    Accelerations "shoulders" before and after a variable deceleration are thought to be caused by partial cord occlusion .Decreased venous return causes a baroreceptor-mediated acceleration.
    Hypertension and decreased arterial oxygen tension secondary to complete cord occlusion results in deceleration.
    Variables occur with head compression secondary to vagal nerve activation, and with movement in the premature fetus[30]
    The timing of the deceleration may occur periodically either with or after the contraction [31].
    Management of Variables


    Change position to where FHR pattern is most improved. Trendelenburg may be helpful.
    Discontinue oxytocin.
    Check for cord prolapse or imminent delivery by vaginal exam.
    Consider amnioinfusion[35-37]
    Administer 100% O2 by tight face mask [4].

    Uterine Contractions [41]

    Uterine contractions are quantified as the number of contractions present in a 10-minute window, averaged over 30 minutes.

    Normal: 5 or less contractions in 10 minutes, averaged over a 30-minute window.

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    Tachysystole: More than 5 contractions in 10 minutes, averaged over a 30-minute window. Applies to both spontaneous or stimulated labor. Tachysystole should always be qualified as to the presence or absence of associated FHR decelerations.

    The terms hyperstimulation and hypercontractility are not defined and should no longer be used.


    Three-Tier Fetal Heart Rate Interpretation System [41]

    Category I : Normal.

    It’s important to monitor your baby’s manufacturing heart rate and rhythm to make sure the baby is doing well during the third trimester of your pregnancy and during labor. The fetal heart rate should be between 110 and 160 beats per minute during labor, according to Johns Hopkins Medicine Health Library.

    The fetal heart rate tracing shows ALL of the following:

    Baseline FHR 110-160 BPM, moderate FHR variability, accelerations may be present or absent, no late or variable decelerations, may have early decelerations.

    Strongly predictive of normal acid-base status at the time of observation. Routine care.

    Category II : Indeterminate.

    The fetal heart rate tracing shows ANY of the following:

    Tachycardia, bradycardia without absent variability, minimal variability, absent variability without recurrent decelerations, marked variability, absence of accelerations after stimulation, recurrent variable manufacturing decelerations with minimal or moderate variability, prolonged deceleration > 2minute but less than 10 minutes, recurrent late decelerations with moderate variability, variable decelerations with other characteristics such as slow return to baseline, and "overshoot".

    Not predictive of abnormal fetal acid-base status, but requires continued surveillance and reevaluation.

    Category III: Abnormal.

    The fetal heart rate tracing shows EITHER of the following:

    Sinusoidal pattern OR absent variability with recurrent late decelerations, recurrent variable decelerations, or bradycardia.

    Predictive of abnormal fetal-acid base status at the time of observation. Depending on the clinical situation, manufacturing efforts to expeditiously resolve the underlying cause of the abnormal fetal heart rate pattern should be made.

    Generally, fetal heart rate monitoring follows this process:

    External monitoring can be done by listening to your baby's heartbeat with a special stethoscope. More often, it is done using two flat devices (sensors). They are held in place with elastic belts on your belly. One sensor uses reflected sound waves (ultrasound) to keep track of your baby's heart rate. The other sensor measures how long your contractions last. manufacturing The sensors are connected to a machine that records the details. Your baby's heartbeat may be heard as a beeping sound or printed out on a chart. How often you have contractions and how long they last may be printed on a chart.

    External monitoring is used for a nonstress test. This test records your baby's heart rate while your baby is moving and not moving. A nonstress test may be done with a fetal ultrasound to check the amount of amniotic fluid.
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    But now British doctors are warning parents-to-be that the home heart monitors can give a false sense of security and lead to delays in medical treatment. In a commentary published today at BMJ.com, Dr. Abhijoy Chakladar and Dr. Hazel Adams, both of manufacturing the Princess Royal Hospital in Britain, tell the tragic story of a pregnant woman who used a home heart monitor to reassure herself that her baby was fine.

    The 34-year-old woman was nearly full-term with her first baby and had experienced a healthy and uneventful 38 weeks of pregnancy. On a Friday, she noticed that the baby wasn’t moving. She used a home fetal heartbeat monitor, and after hearing what she believed to be her baby’s heartbeat, was reassured that nothing was wrong. When she finally visited the doctor on Monday, an ultrasound scan showed the baby had died.

    Reasons for the Procedure

    Fetal heart rate monitoring is used in nearly every pregnancy to assess fetal well-being and identify any changes that might be associated with problems during pregnancy or labor. Fetal manufacturing heart rate monitoring is especially helpful for high-risk pregnancy conditions such as diabetes, high blood pressure, and problems with fetal growth.

    Situations during pregnancy in which fetal heart rate monitoring may be used include, but are not limited to, assessment of fetal heart rate during prenatal physician visits and monitoring the effect of preterm labor medications on the fetus.
    With internal monitoring, you may experience some slight discomfort during the insertion of the electrode.

    Risks of internal monitoring include, but are not limited to, infection and bruising of the fetal scalp or other body part.

    Internal fetal heart rate monitoring is contraindicated in women with active herpes lesions on the cervix or vagina because of the risk of transferring the infection to the fetus.
    Before the Procedure

    Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.

    Advice on this differs depending on the manufacturing organization you listen to.

    Both Countthekicks.org and The American Pregnancy Association cite The American Congress of Obstetricians and Gynecologists (ACOG) as suggesting that moms-to-be count kicks from their third trimester and that most babies will usually make ten movements in two hours.

    (Note ‘movements.’ These could be rolling, kicking or swishing but do not include hiccups).

    However, Madeformums points out that this is really pretty outdated advice now.

    Kickscount, the National Health Service and Babycentre all agree that, rather than counting kicks, pregnant mommies should focus on what movement is normal for their baby.

    Every baby is different!

    You can expect to start feeling you baby move anytime from about 16 to 22 weeks.

    Second-time moms are likely to feel their baby a little sooner than first-time moms.

    If you haven’t felt manufacturing anything by 22 weeks, don’t panic! Just give your doctor or midwife a call so they can put your mind at rest.

    Baby routine

    When you start to feel your baby move, you will likely begin to notice a pattern which is individual to them.

    Placement of an internal electrode requires that the amniotic membranes (the fluid-filled sac that surrounds the fetus during pregnancy) be broken, and the cervix be dilated (opened) several centimeters to allow contact with the fetal scalp or other body part.

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    Maybe you feel them more in the morning, perhaps straight after your lunch! My little boy seemed to come to life just as I lay down to sleep each night!

    You’ll begin to realize how many movements are typical for your baby, and this is what you should be looking out for each day, rather than a set number of kicks.

    What about as baby get bigger?

    Bellybelly points out that after 36 weeks, baby is so manufacturing big that they have much less room for huge kicks and big movements.

    It often used to be said that this meant you should expect to feel a reduction in movements towards the end of pregnancy.

    Now that is not considered to be the case. You should still feel baby move a similar amount each day, but perhaps they will be gentle nudges and pushes rather than a huge roly-poly!

    I haven’t felt baby in a while. Is there anything else I can try?

    Here are a few things to try to get little one moving:

    Have a sugary snack.
    Try a cold drink.
    Do a few jumping jacks! (Just a few!)
    Have a lie-down.
    Play some music
    When should I seek reassurance?

    If you’ve tried all of the above and haven’t felt your little one move in a while, then give your doctor or midwife a call.

    Living in the UK, with our state-funded National Health Service, I was very aware that the midwives were already so, so busy. I was worried about being a nuisance and that I might be wasting their time.

    I couldn’t have been more wrong!

    On the two occasions that I was worried that my little one had gone a little quiet, the midwives I met with were wonderful. They put me 100% at ease and told me that I’d done exactly the right thing by giving them a call.

    They even finished (both times) by telling me to come back again if I had any further concerns at all.

    And guess what? Our little boy was absolutely fine on both occasions! But boy am I glad I went in to put my mind at ease!

    You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear. The consent form for fetal heart rate monitoring may be included as part of the general consent for your labor and birth.


    If fetal heart rate monitoring is performed in manufacturing conjunction with another monitoring procedure, such as a nonstress test or biophysical profile, you may be asked to eat a meal before the procedure. This can help increase fetal activity. You may or may not be able to eat or drink with fetal heart rate monitoring during labor.


    Although the gel applied to the skin during the procedure does not stain clothing, you may wish to wear older clothing or a hospital gown, as the gel may not be completely removed from your skin afterwards.


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    One benefit of EFM is to detect early fetal distress resulting from fetal hypoxia and metabolic acidosis. In the United States, an estimated 700 infant deaths per year are associated with manufacturing intrauterine hypoxia and birth asphyxia.5 Another benefit of EFM includes closer assessment of high-risk mothers. Most patients who undergo internal fetal monitoring during labor accept monitoring as a positive experience.6

    The most important risk of EFM is its tendency to produce false-positive results. Unfortunately, precise information about the frequency of false-positive results is lacking, and this lack is due in large part to the absence of accepted definitions of fetal distress.7 Meta-analysis of all published randomized trials has shown that EFM is associated with increased rates of manufacturing surgical intervention resulting in increased costs.8 These manufacturing results show that 38 extra cesarean deliveries and 30 extra forceps operations are performed per 1,000 births with continuous EFM versus intermittent auscultation. Variable and inconsistent interpretation of tracings by clinicians may affect management of patients. The effect of continuous EFM monitoring on malpractice liability has not been well established. Other rare risks associated with EFM include fetal scalp infection and uterine perforation with the intra-uterine tocometer or catheter.


    Based upon your medical condition, your physician may request other specific preparation.


    During the Procedure

    Fetal heart rate monitoring may be performed in your physician's office, on an outpatient basis, or as part of your stay in a hospital. Procedures may vary depending on your condition and your hospital's practices.


    Dr. Chakladar said there was no way to know if the baby’s death could have been prevented, but the fetal heart monitor gave false reassurance and delayed the woman from seeking medical attention. It is difficult for an inexperienced person to distinguish between a baby’s heartbeat and the whooshing sounds of a mother’s own pulse or blood flow. And even when parents do find the fetal manufacturing heartbeat, there is no way for them to know whether the baby is well or in distress.

    “This is something that comes only with experience,” Dr. Chakladar said in an e-mail message. “In hospital, fetal health is assessed by experienced midwives and doctors who take a team approach.”

    Dr. Chakladar notes that parents are not at fault and that there is nothing wrong with listening to a baby’s heartbeat. He said the devices should, however, never be used for reassurance. If a mother is concerned and feels she needs reassurance, she should immediately consult her doctor.

    “On their own, these monitors are harmless; it is their improper use by parents to reassure themselves which can be dangerous,” Dr. Chakladar said. “These monitors can be great fun, and I would manufacturing personally buy one. However, they are dangerous if they are used by untrained people as an alternative to seeking medical advice.”

    Some clinicians have argued that this unproven technology has become the standard for all patients designated high risk and has been widely applied to low-risk patients as well.9 The worldwide acceptance of EFM reflects a confidence in the importance of electronic monitoring and concerns about the applicability of auscultation.10 However, in a 1996 report, the U.S. Preventive Services Task Force7 did not recommend the use of routine EFM in low-risk women in labor.

    Interpreting FHR Patterns
    A systematic approach is recommended when reading FHR recordings to avoid misinterpretation (Table 2). The FHR recordings may be interpreted as reassuring, nonreassuring or ominous, according to the pattern of the tracing. Reassuring patterns correlate well with a good fetal outcome, while nonreassuring patterns do not. Evaluation of fetal well-being using fetal scalp stimulation, pH measurement, or both, is manufacturing recommended for use in patients with nonreassuring patterns.11,12 Evaluation for manufacturing immediate delivery is recommended for patients with ominous patterns. Table 3 lists examples of nonreassuring and ominous patterns. The FHR tracing should be interpreted only in the context of the clinical scenario, and any therapeutic intervention should consider the maternal condition as well as that of the fetus. For example, fetuses with intrauterine growth restriction are unusually susceptible to the effect of hypoxemia, which tends to progress rapidly.

    Doctors may use internal or external devices to monitor the fetal heart beat. It’s most often measured using an ultrasound device. Sometimes your doctor will instead attach an internal monitoring device directly to the baby’s scalp to help measure the heart rate more accurately.

    Your doctor will be looking for different kinds of heart rates, including accelerations and decelerations. They’ll watch for any heart-related changes that may occur, as these are often signs that either the baby or the mom is at physical risk. Such signs of risk might prompt the doctor to take immediate action to restore the safety of the fetus and mother.

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    Electronic fetal monitor at home doppler for baby heart monitor

    External monitoring is also manufacturing done for a contraction stress test. This test records changes in your baby's heart rate when you have contractions. It may be done to check on your baby's health if your baby does not move enough during a nonstress test. It may help predict whether your baby can handle the stress of labor and vaginal delivery.

    Sometimes external monitoring is done remotely. This is called telemetry. It allows you to be checked without being hooked up to a machine. At some hospitals, the sensors can send the details about your baby's heart rate and your contractions to a remote monitor. This monitor is usually at a nurse's station. Using a remote monitor allows you to walk around freely.

    External fetal heart monitoring

    Depending on the type of procedure, you may be asked to undress from the waist down. Or you may need to remove all of your clothes and wear a hospital gown.
    You will lie on your back on an exam table.
    The healthcare provider will put a clear gel on your abdomen.
    The provider will press the transducer against your skin. The provider will move it around until he or she finds the fetal heartbeat. You will be able to hear the sound of the fetal heart rate with Doppler or an electronic monitor.
    During labor, the provider may check the fetal heart rate at intervals or nonstop, based on your condition and the condition of your baby.
    For continuous electronic monitoring, the provider will connect the transducer to the monitor with a cable. A wide elastic belt will be put around you to hold the transducer in place.
    The provider will record the fetal heart rate. With continuous monitoring, the fetal heart pattern will be displayed on a computer screen and printed on paper.
    You may not be able to get out of bed with nonstop external fetal heart rate monitoring.
    Once the procedure is done, the provider will wipe off the gel.


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