If your baby is not coping well, this may well be reflected in the pattern of their heartbeat. Which method will be used? National guidelines NICE- National Institute for Clinical Excellence recommend the use of EFM in the following circumstances: Your baby from external assessment seems smaller than expected You have high blood pressure You are expecting twins or triplets You had a caesarean birth with any of your previous pregnancies Your labour has been induced for any reason on this list.
Your baby is overdue more than 42 weeks Your baby is premature before 37 weeks. EFM will also be recommended in the following circumstances: You have a health problem such as; Diabetes; problems with your heart or kidneys or infection Your baby is breech presentation going to be born bottom first. What are the benefits and risks? Your obstetric team and the fetal team at GOSH will discuss the safest mode of delivery for you and your baby, and this may include the possibility of early delivery before 37 weeks or a Caesarean section may be advised.
After birth, babies usually do very well even though you took medication during pregnancy. After your baby is born, we recommend that they have an electrocardiogram ECG to check their heart rhythm. The doctors looking after your baby will then talk to you about whether any further treatment or monitoring is needed.
In either situation, a period of monitoring will be required and in most cases medications are still used to control the fast heart rate. Your baby will be referred to a paediatric cardiologist who will review your baby, ECG and ECHO results and will help to manage the medications your baby needs.
Occasionally more than one medication is required. Before birth, please call the Fetal Cardiac Nurse Specialists on or send them an email to gos-tr. After birth, you can call the Electrophysiology team on extension or send an email to gos. Call them on 44 66 or visit their website at www. With internal monitoring, you may have some slight discomfort when the electrode is put in your uterus. 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:. 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. You do not need any special care after external fetal heart monitoring.
You may go back to your normal diet and activity unless your healthcare provider tells you otherwise. The provider will clean the site with an antiseptic. Health Home Treatments, Tests and Therapies. Why might I need fetal heart monitoring? 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. When treatment is required, the goal is to control the speed of the fetal heart rate and prevent the development of hydrops, enabling delivery at term.
Delivery should take place at a center with the highest quality congenital heart program, ensuring the expertise and resources required to treat fetal arrhythmias during delivery and after birth, including an advanced neonatal or cardiac intensive care unit NICU or CICU , if needed.
Delivery and postnatal care should be carefully planned and coordinated across a team of maternal-fetal medicine specialists, cardiologists and neonatologists experienced in these rare conditions. In some cases, a caesarean delivery may be advised. Here, the pediatric cardiologists treating your baby have been an integral part of their care team since before birth. In some cases, the heart rate may slow down to a normal rate over time, without intervention.
Babies should be followed closely by a pediatric cardiologist experience in congenital heart conditions until the condition is completely resolved.
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