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Pregnancy—monitoring your baby in the antenatal ward

Welcome to the Mater Mothers’ Hospitals Antenatal Ward

Evidence has shown that monitoring your baby in a high risk pregnancy is crucial for the detection of those babies at risk. Fetal movement and fetal heart rate monitoring are recommended in a high risk pregnancy.

This document provides you with information on the various ways in which we will be monitoring your baby during your stay.

Feeling the position and size of your baby— abdominal palpation

The midwife will ask you to lie on your back and will place a small pillow under your left hip. She or he will use their hands to feel your abdomen to determine how your baby is positioned. This will usually be done prior to listening to your baby's heartbeat.

Baby’s movements

Your midwife will regularly ask you about your baby's movements. It is important for you to speak to your midwife if you feel your baby is not moving as he or she normally does. Your midwife will listen to your baby's heartbeat and may ask you to count your baby's movements over a period of time.

Listening to your baby’s heartbeat

There are two different ways of listening to your baby's heartbeat while you are on the antenatal ward. Before using either of these your midwife will perform an abdominal palpation to decide the best place to situate the transducer for optimal results. When the transducer of either device is placed on your abdomen it may take a few seconds for you to be able to hear your baby's heart beat.

  1. Doppler—a portable hand held device that will have gel applied to the small transducer. The midwife will usually listen for one minute.
  2. Cardiotocograph (CTG)—measures your baby's response to movement and uterine activity. The transducer has a larger diameter than the Doppler and will be attached with elastic straps that stretch around your abdomen. A second transducer is placed near the top of your uterus and this will monitor any contractions or tightenings that you may be experiencing—this will also be attached with a strap.

The CTG will trace onto graph paper. The top graph is a record of your baby's heartbeat and the lower graph indicates any contractions or tightenings. You will be given a button to push when you feel your baby move and your baby's movements will be recorded as small marks that look like commas in between the two graphs.

Your midwife will make written comments directly onto the trace if there is any significant information that is relevant to a particular portion of the trace.

Ultrasound

You may be asked to go to Maternal Fetal Medicine (MFM) department on level 7 for an ultrasound. You will either go alone, or be accompanied by a midwife or wards person. You may need to go in a wheelchair or on your bed, depending on your circumstances.

During your ultrasound a transducer will be placed on your abdomen, with some warmed gel, and moved around to capture specific images of your baby which are displayed on a screen. The ultrasound can be used to monitor several features of your baby and his/her condition and environment such as:

  • Position of your baby and the placenta
  • How your baby is growing
  • How much amniotic fluid is around your baby
  • The rate and strength of flow in some of your baby's umbilical cord and some of their vessels.

References

  1. Froen JF, Holm Tveit JV, Saastad E, Bordahl PE, Stray-Pedersen B, Heazell AEP, Flenady V, Fretts RC. Management of Decreased Fetal Movements. Semin Perinat 32:307-311 2008 Elsevier Inc.
  2. Froen JF, Heazell AEP, Holm Tveit JV, Saastad E, Fretts RC, Flenady V. Fetal Movement Assessment. Semin Perinat 32:243-246 2008 Elsevier Inc.
  3. Yatt SN, Rhoads SJ. A Primer on Antenatal testing for Neonatal Nurses: Part2: Tests of Fetal Well-Being, Advances in Neonatal Care, Vol.6, No 5 (October), 2006 pp 228-241
  4. Olesen AG, Svare JA. Decreased fetal movements: background, assessment, and clinical management. Acta Obstet Gynecol 2004; 83: 818-826
  5. Su LL, Chong YS. Common modalities for routine antepartum foetal monitoring: are they evidence-based? Singapore Med J 2006: 47(10):830

© 2012 Mater Misericordiae Ltd. ACN 096 708 922

Mater acknowledges consumer consultation in the development of this patient information.
Last modified 17/11/2015.
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