• CONTRACTIONS AND

FETAL HEART TONES

• ARLENE TIMBAL-OLINARES
• TERMINOLOGIES
• Increment or Crescendo-from beginning of
contraction until it increases
• Acme or Apex- height/peak of contraction
• Decrement or Decrescendo- from the height
of contraction until it decreases
• Duration- beginning of the contraction to the
end of the same contraction
• Interval- end of one contraction to the
beginning of next contraction
• Frequency- beginning of one contraction to
the beginning of next
contraction
• Intensity – strength of contraction
• SIGNS OF FETAL DISTRESS
FHT of <120 >180bpm
Meconium-stained amniotic fluid
Fetal thrashing – hyperactivity of fetus due to
lack of oxygen
NORMAL FHT- 120-180
• FETAL HEART RATE MONITORING
• Is the process of checking the
condition of the baby during
labor and delivery by
monitoring his or her heart
rate with special equipment.
• PURPOSE/IMPORTANCE
• May help detect changes in the normal heart
rate pattern during labor.
• If certain changes are detected, steps can be
taken to help treat the underlying problem.
• Can also help prevent treatments that are
needed
• A normal FHR can reassure both the mother
and health care provider that it is safe to
continue labor if no problems are present.
• OTHER TYPES OF FETAL HEART
MONITORING
• Fetoscope
• Fetal Heart Doppler
• Electronic Fetal Monitor
• Internal Fetal Monitor
• Telemetry Monitoring
• FETOSCOPE
• This is a special type of stethoscope used for
listening to a baby
• FETAL HEART DOPPLER
• This is handheld ultrasound device that
transmits the sound of the baby’s heartbeat
either through a speaker or into ear pieces that
are attached.
• ELECTRONIC FETAL MONITORING
• This is an ultrasound device used during labor
and birth, or during certain testing ( non-stress
test, contraction stress test, etc.) to record the
baby’s heart rate and sometimes mother’s
contractions.
• It provides an ongoing record ( fetal hr tracing
)that can be read by health care provider
which can be reviewed more frequently if
problems arise.
• Electronic Fetal Monitor
• INTERNAL FETAL MONITOR
• It is an internal monitoring with an electrode
attached to the baby’s head to record heart
tones, and a pressure catheter to record
contractions.
• It can be used only after the membranes of the
amniotic sac have ruptured ( after your water
breaks or is broken )
• Internal Fetal Monitor
• TELEMETRY MONITORING
• It is a lot like the regular fetal monitoring,
however, one can maintain mobility

• FETAL DOPPLER USE

• Lying down ( the best way )
• Expose the abdomen
• Apply a generous amount of ultrasound gel to
the fetal doppler probe.
• Begin with the midline of the abdomen
• Probe angled slowly in search for FHT
• A full bladder can make it easier to find the
heart beat
• Keep from dragging the probe around

• WHEN CAN THE FETAL DOPPLER BE

USED?
• In some women, Fetal Heart can be detected
as early as 8-12 weeks
• FH should be audible 95% of the time in 12-
week pregnancies, and nearly 100 % of the
time after 14 weeks
• Earlier in pregnancy, between 8-12 weeks,
success of finding the HR can have to do with
the quality of the device.

• How do you know if it’s the baby’s

Heartbeat not the mother’s?
• The easiest and conclusive way is by the heart
rate or BPM
Heart Rate
Baby between 120 and 180 bpm
Mother much less 60-100 BPM
• WHEN CAN THE FETAL DOPPLER BE
USED?
• In some women, Fetal Heart can be detected
as early as 8-12 weeks
• FH should be audible 95% of the time in 12-
week pregnancies, and nearly 100 % of the
time after 14 weeks
• Earlier in pregnancy, between 8-12 weeks,
success of finding the HR can have to do with
the quality of the device.

• Fetal Sounds
• A galloping horse is what the baby’s heart
beat will sound like and will be about twice as
fast as the mother’s heart rate.
• An average normal fetal heart rate is between
120-180 BPM
• Fetal Heart Rate Facts
• What should the baby’s heart rate be?
The normal fetal heart rate is between 110 to
180 beats per minute but can vary.
Fluctuations of the FHR ( usually associated
with fetal movement ) during different
 periods of the day are common and often rise
above 160, going as high as 180- 190 and are
considered normal
• WHAT HAPPENS IF THE
FETAL HEART RATE
PATTERN IS ABNORMAL?
Abnormal FHR patterns do not
always mean there is problem.
Other tests may be done to get
a better idea of what is going
on with the baby.
• Reference:
• Fetal dopplerFACTS.org
• The American College of Obstetrician and
Gynecologists