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A fetal monitor helps maternity teams assess the baby’s condition by recording fetal heart rate and, with cardiotocography (CTG), uterine activity. The readings can be displayed on screen and printed as a trace in real time. They allow clinicians to review patterns over time and identify changes that may need further assessment.
CTG and Doppler ultrasound examinations provide different information and are used according to the clinical situation. Many external fetal heart rate monitors themselves use Doppler ultrasound to detect the heartbeat. CTG is therefore not a universal replacement for an ultrasound examination.
Where fetal monitors are used
Cardiotocographs are widely used in obstetric departments and maternity units. Depending on the model and its configuration, they can record:
- fetal heart rate and, on suitable systems, fetal movements;
- uterine activity, including the frequency and duration of contractions;
- additional maternal observations, where the relevant monitoring modules are available.
Some combined fetal and maternal monitors also measure the mother’s pulse, blood pressure and blood oxygen saturation (SpO₂), and provide maternal ECG monitoring. For example, these are among the parameters listed for the Philips Avalon FM50. The precise capabilities depend on the device: a basic CTG unit should not be assumed to measure maternal breathing or provide every vital-sign measurement.
The uterine activity trace contributes to assessment of the contraction pattern. Fetal heart rate findings are considered alongside maternal observations and the rest of the clinical assessment. NICE guidance on fetal monitoring in labour explains that heart rate monitoring informs assessment of fetal wellbeing and is not a standalone diagnostic test.
Depending on the equipment, recordings can be stored, printed or transferred to a central monitoring system over the hospital network. This helps staff review the trace and retain a record of monitoring.
Fetal monitors are supplied by manufacturers in the United States, Russia, China, the Netherlands, South Korea and elsewhere in Europe and beyond. Their specifications and available accessories vary, so a comparison should focus on the intended clinical use rather than the country of manufacture alone.
How to choose a fetal monitoring system
The choice of monitor should reflect the needs of the maternity service, the measurements required and the way the device will be used. The timing and type of fetal monitoring depend on gestational age, clinical concerns and the care plan. During labour, NICE recommends intermittent listening to the fetal heartbeat for women at low risk of complications, with continuous CTG offered when risk factors or persistent concerns are present.
Check that the system meets the applicable requirements in the country where it will be used and that its performance, maintenance needs and approved accessories are documented. When comparing devices, consider:
- measurement accuracy, signal quality and the ability to distinguish maternal and fetal heart rates;
- the weight and dimensions of the unit;
- the warranty period;
- access to servicing by the manufacturer or an authorised service provider;
- the purchase cost, included accessories and available functions;
- display size, technology and readability;
- the availability and operating time of a rechargeable battery;
- whether the system is portable or intended for a fixed location;
- support for external monitoring and, where required, internal monitoring methods;
- the controls, such as physical buttons or a touchscreen.
A useful feature set matters, but reliable measurements and clear traces are essential. Staff should be able to obtain the required information consistently and recognise problems such as signal loss.
Local technical support also deserves attention. A manufacturer or authorised representative with service facilities in the country of use can make it easier to arrange maintenance, obtain replacement parts and resolve faults promptly.
Original source: Zaplata — Fetal monitors for obstetric assessment.
