Understanding the Difference Between External Fetal Monitoring and Intermittent Fetal Monitoring

Monitoring the fetal well-being during pregnancy and labor is essential to ensure the health and safety of both the mother and the unborn baby. Two common methods of fetal monitoring are External Fetal Monitoring (EFM) and Intermittent Fetal Monitoring (IFM). In this blog, we will explore the differences between these monitoring techniques and discuss their importance in obstetric care.

External Fetal Monitoring (EFM): External Fetal Monitoring is a continuous method of monitoring the baby's heartbeat and uterine contractions during labor. EFM involves placing sensors externally on the mother's abdomen. These sensors called tocodynamometers and ultrasound transducers, detect and record the fetal heart rate and uterine contractions, respectively. EFM provides a continuous tracing of the baby's heartbeat and allows healthcare providers to monitor any variations or abnormalities. It helps in the early detection of potential problems, such as fetal distress or uterine hyperactivity, allowing for timely interventions.

EFM is important as it provides valuable information about the baby's well-being and the progress of labor. It helps healthcare providers identify any signs of fetal distress, which may indicate a lack of oxygen or compromised fetal circulation. Additionally, EFM aids in assessing the effectiveness and timing of contractions, ensuring optimal progress of labor. It provides continuous monitoring, allowing healthcare providers to make informed decisions regarding interventions, such as pain management or emergency deliveries if necessary.

Reference:

Alfirevic, Z., Devane, D., Gyte, G. M., & Cuthbert, A. (2013). Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. The Cochrane Database of Systematic Reviews, 5, CD006066. doi:10.1002/14651858.CD006066.pub2

National Institute for Health and Care Excellence. (2017). Intrapartum care for healthy women and babies. Retrieved from https://www.nice.org.uk/guidance/cg190/chapter/Recommendations#monitoring-for-healthy-women-during-labour

Intermittent Fetal Monitoring (IFM):

Intermittent Fetal Monitoring involves periodic checks of the fetal heartbeat and uterine contractions during labor. It is typically performed at specific intervals, such as every 15 or 30 minutes, by using a handheld Doppler device or a Pinard stethoscope. Healthcare providers listen to the baby's heartbeat and evaluate the frequency, duration, and strength of contractions manually.

IFM is important as it allows healthcare providers to assess the baby's well-being and ensure that it is tolerating labor. Although IFM does not provide continuous monitoring like EFM, it remains a valuable technique in low-risk pregnancies where continuous monitoring may not be necessary. IFM helps detect any sudden changes in the fetal heartbeat or irregularities in contractions between the intermittent checks. It provides a hands-on approach, enabling healthcare providers to establish a reassuring pattern of fetal heart rate and contractions throughout labor.

Reference:

Alfirevic, Z., Devane, D., & Gyte, G. M. (2006). Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. The Cochrane Database of Systematic Reviews, 3, CD006066. doi:10.1002/14651858.CD006066

Both External Fetal Monitoring (EFM) and Intermittent Fetal Monitoring (IFM) play essential roles in monitoring the well-being of the fetus during labor. EFM provides continuous monitoring of the baby's heart rate and uterine contractions, allowing for early detection of potential complications. IFM, on the other hand, involves periodic checks to ensure the baby's well-being and labor progression. The choice between these two monitoring techniques depends on various factors, including the risk level of the pregnancy and individual patient needs. By implementing appropriate monitoring methods, healthcare providers can ensure optimal care and make timely interventions when necessary to promote a safe and healthy delivery.