New Millennium Obstetrics & Gynecology

Fetal Monitoring

When we talk about fetal monitoring, I am sure that most of you see a woman in bed with straps around her pregnant form attached to a beeping machine. That is one type of fetal monitoring, electronic fetal monitoring. In this FAQ I hope to show you the different types of monitoring, the benefits and disadvantages of each type of monitoring, and how to use monitoring to help you achieve a safe and happy birth.

Robin Elise Weiss, ICCE, CD(DONA), NACA

What is fetal monitoring?

Fetal monitoring is defined as watching the baby's heart rate for indicators of stress, usually during labor and birth.

Define the types of fetal monitoring:

Fetoscope: This is a special type of stethoscope used for listening to a baby. There are many types of fetoscopes available, and a regular stethoscope works as well. This can usually be used after about 18 weeks.
Doppler: This is a handheld ultrasound device that transmits the sounds of the baby's heart rate either through a speaker or into ear pieces that are attached. This can generally pick up heart tones after 12 weeks gestation.

Telemetry Monitoring: It is a lot like the regular Electronic Fetal Monitoring, however, one can maintain mobility.

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 can be used intermittently or continuously.

Internal Fetal Monitoring: 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. This is also used during labor and birth, however, it is not used intermittently.

What are the benefits and risks?

Fetoscope: This method is non-invasive, simple to use, and has a live person on the other end (This can prevent some of the errors that are mechanical). This gives mother the mobility to deal with her labor, shower, etc. It does require that the person using it be trained, although it is a standard procedure taught in every medical and nursing type institution. In the case of high risk, induced, or with certain medications, it cannot provide the round the clock monitoring that may be necessary.
Doppler: This method is also used intermittently, requires little training to use, has a live person on the other end, and allows mother to maintain her mobility. It may also be easier to use during a contraction. This device does use ultrasound and does not provide the continuous monitoring needed for high risk labors.
Electronic Fetal Monitoring: This method provides beat to beat view of the baby's heart tones, in relationship to mother's contractions. This may be used either continuously or intermittently. This is a benefit for the high risk mother, but of questionable benefit to the low risk mother. This method does use ultrasound; leaves room for mechanical error, which may cause incorrect interpretation, unnecessary interventions etc.; loss of maternal mobility (when in use), which may slow labor; and may switch attention from the mother to the machine.

Internal Monitoring: This is more accurate than the electronic monitoring, does not use ultrasound, and can provide continuous monitoring for the high risk mother. This method requires that your water be broken (An amniotomy will be performed if you water is still intact.), and that you be 2–3 centimeters dilated. Amniotomy adds risks of its own; however, the risks and benefits of each procedure must be weighed. This type of monitoring is almost exclusively used in high-risk situations or when more accurate types of monitoring may prevent other unnecessary interventions. This type of monitoring also has been associated with fetal injury (from the electrode), infection for mother or baby, etc.

Telemetry Monitoring: This is the "newest" type of monitoring available. It uses radio waves, connected to a transmitter on your thigh, to transmit the baby's heart tones to the nurses' station. You maintain your mobility, and have constant monitoring, but again, continuous monitoring for the low risk mother is very questionable in benefit.

4(D)imensional Ultrasound

4D Ultrasound System marks a new dimension in obstetric imaging. It features advanced signal processing, which produces higher-quality ultrasound images. But what makes the system unique is exclusive GE 4D technology.

GE 4D Ultrasound represents the difference between video and a still photograph. Through this revolutionary technology, your baby's three-dimensional image is continuously updated, providing a "live action" view that leads to a number of medical benefits. Physicians and sonographers can better analyze fetal development, so you'll know what to expect and can feel confident during your pregnancy.

4D Ultrasound System is just one more example of the breakthroughs evolving every year from the scientists and engineers at GE Medical Systems – breakthroughs designed to provide you with all the information and security you need to ensure your family peace of mind and good health. You can get your questions answered about 4D Ultrasound at New Millennium OB/GYN. Here are examples of 4D Ultrasounds recently taken at New Millennium.

With 4D Ultrasound you actually see the baby move. 4D Ultrasound shows live action images of your unborn child or of any internal anatomy.

What is "4D"/"4D Ultrasound"?
What are the advantages of the 4D technology?
Are there any risks related to 3D or 4D ultrasound?
Does a 4D Ultrasound exam take longer than a traditional ultrasound exam?
Why do the 4D Ultrasound images have a golden hue?
How long does an ultrasound exam last?
Do I have to make any special preparations for an ultrasound exam?
What are the advantages of the 4D technology?
What is Volume Rendering?
Beyond pretty baby pictures, are there other applications for 4D Ultrasound?

What is "4D"/"4D Ultrasound"?
"4D" is shorthand for "four-dimensional” – the fourth dimension being time. As far as ultrasound is concerned, 4D Ultrasound is the latest ultrasound technology and it is exclusive to GE. 4D Ultrasound takes three-dimensional ultrasound images and adds the element of time to the process. The result: live action images of your unborn child or of any internal anatomy.

What are the advantages of the 4D technology?
In contrast to other 3D imaging diagnostic processes, 4D allows your doctor to visualize internal anatomy moving in real-time. For example: Movement patterns of fetuses allows conclusions to be drawn about their development; increase of accuracy in ultrasound guided biopsies thanks to the visualization of needle movements in real time in all 3 planes. So physicians and sonographers can detect or rule out any number of issues, from vascular anomalies and genetic syndromes.

Are there any risks related to 3D or 4D ultrasound?
No. 3D and 4D Ultrasound both utilize sound waves to look inside the body. The technology is similar to radar. A probe placed on the body emits sound waves into the body, listens for the return echo, and generates an image.

Does a 4D Ultrasound exam take longer than a traditional ultrasound exam?
No. Even though a 4D Ultrasound exam employs slightly different technology, you should not anticipate a longer exam.

Why do the 4D Ultrasound images have a golden hue?
Physicians have the option of selecting different tints in reviewing images. GE has found that the golden hue is aesthetically pleasing to the eye and shows excellent shadows and highlights.

How long does an ultrasound exam last?
There are many factors that impact the length of an ultrasound exam, including the position of the baby in the womb. However, a typical exam for an expectant mother lasts approximately 30–50 minutes.

Do I have to make any special preparations for an ultrasound exam?
Ultrasound is a safe, non-invasive exam that does not typically require any exam preparation. Still, please consult with your physician first on any requirements.

What are the advantages of the 4D technology?
Displaying the entire volume of an object that is being examined makes it possible to analyze the tissue concerned. 4D allows doctors and sonographers to analyze fetal motion and perform exams previously unavailable.

What is Volume Rendering?
Volume Rendering is the process of capturing ultrasound image information and compiling it into a three-dimensional image. Volume Rendering allows doctors to visualize internal anatomy in every direction.

Beyond pretty baby pictures, are there other applications for 4D Ultrasound?
Yes. The Voluson 730 is a full-service ultrasound system that can be used for breast imaging, interventional urology and general imaging. As with all ultrasound systems, it can be used to research the following:

Determining fetal age
Analyzing fetal development
Evaluating multiple and/or high-risk pregnancies
Detecting fetal abnormalities
Detecting structural problem with uterus
Detecting placental abnormalities
Detecting abnormal bleeding
Determining entopic pregnancy and other abnormalities of pregnancy
Detecting ovarian tumor/fibroids
Locating the placenta

da Vinci Hysterectomy

da Vinci Hysterectomy offers several potential benefits over traditional approaches, including:

Significantly less pain
Minimal blood loss and need for transfusion
Fewer complications
Shorter hospital stay
Quicker recovery and return to normal activities
Small incisions for minimal scarring
Better outcomes and patient satisfaction, in many cases

This procedure is performed using the da Vinci Surgical System. It is a breakthrough surgical platform that enables gynecologists to operate with unmatched precision, vision and control. By overcoming the limitations of both traditional open and laparoscopic surgery, da Vinci is revolutionizing gynecologic surgery for women. Read about how da Vinci Surgery enables gynecologists to perform the most precise, minimally invasive hysterectomy available today - da Vinci Hysterectomy.

Links

Essure Birth Control
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Halo Breast Pap Test
da Vinci Hysterectomy