Noninvasive fetal electrocardiography monitoring is a technique carried out during antenatal period or labor to measure the fetal heart rate and electrical activity of the fetal heart and associated uterine contraction using surface electrodes placed on the maternal abdomen.
Purposes
- To assess the FHR
- To monitor morphological information of FECG such as PR, ST, and QT intervals
- To note the abdominal contraction of mother
- To count the fetal movements
- To assess the fetal position
Indications
Noninvasive fetal electrocardiography is commonly indicated in the following situations:
- Maternal anemia
- History of heart disease, diabetes mellitus, or hyperthyroidism
- Oligohydramnios
- Obesity
- Multiple pregnancies
- Preterm labor
- Post-term labor
- Malpositioning and malpresentation of fetus
Parts of Non-invasive Foetal Electrocardiography
- Tocodynamometer pads
- Belt to secure the pads
- Probe to count the uterine activity
- Monitor
- ECG recorder
Advantages
- This device can provide more accurate FHR
- estimation than Doppler ultrasound.
- NI-FECG gives an opportunity to enable the morphological analysis of the FECG, which is vital for determining whether an observed FHR event is normal or abnormal.
- NI-FECG is a noninvasive technique and can be used in earlier stages of pregnancy also.
- This technique is suitable alternative to Doppler cardiotocography in the case of high-risk pregnancies.
Disadvantages
- This technique has the problem of low signal-to-noise ratio of the FECG signal on the abdominal mixture signal, which consists of a dominant maternal ECG component, FECG, and noise.
Due to the presence of vernix caseosa, NI-FECG cannot be performed effectively due to nonconductivity. - Fetal movements can interfere with reading.
Preparation
- Articles:
- Assemble articles needed for the procedure.
- Check the working condition of the machine.
Articles needed
- NI-FECG machine
- Disposable gloves to prevent cross infection
- Gel to apply on pads
- Cotton pad or tissue paper to clean the abdomen after the procedure
- Antiseptic solution to clean the pads (according to manufacturer’s instruction)
- Client:
- Explain the procedure to the expectant mother to win confidence and cooperation.
- Provide privacy.
- Loosen the clothes over abdomen.
- Elevate the head end to 45° to enhance comfort.
Procedure
- Perform hand hygiene
- Wear gloves.
- Connect the monitor to the electric outlet.
- Switch on the monitor button.
- Clean the tocodynamometer pads with prescribed antiseptic swabs.
- Apply gel over the pad.
- Place the pads on the mother’s abdomen, one just above the umbilicus and right iliac fossa (placement may vary based on fetal presentation and position).
- Note the readings on monitor.
- Secure the pads with belts.
- Provide the left lateral position to the mother.
- Switch on the ECG recorder.
- Give the probe to mother and instruct her to press it whenever he feels fetal movements.
- Continue to assess the reading for a prescribed period of time.
- Switch off the device after a prescribed time.
- Loosen the belt and remove the pads from abdomen.
- Clean the area with tissue paper or cotton.
Aftercare
- Assist the mother to adjust her clothing.
- Clean the pads and keep it in its box.
- Replace the articles.
- Document the procedure.
- Notify to the senior staff or the doctor if there are any abnormal findings.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Marcia London, Ruth Bindler, Principles of Paediatric Nursing: Caring for Children, 8th Edition, 2023, Pearson Publications, ISBN-13: 9780136859840
- Naveen Bajaj, Rajesh Kumar, Manual of Newborn Nursing, 2nd Edition, 2023, Jaypee Publishers, ISBN:978-9354659294
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
Stories are the threads that bind us; through them, we understand each other, grow, and heal.
JOHN NOORD
Connect with “Nurses Lab Editorial Team”
I hope you found this information helpful. Do you have any questions or comments? Kindly write in comments section. Subscribe the Blog with your email so you can stay updated on upcoming events and the latest articles.
