External electronic fetal monitoring is an indirect, noninvasive procedure involving the use of two devices, an ultrasound transducer and a tocotransducer, placed on the patient’s abdomen.

It aids in evaluating fetal well-being and uterine contractions during labor.

Devices are held in place with an elastic stockinette or with plastic or soft straps.

High-frequency sound waves are transmitted by the ultrasound transducer and aimed at the fetal heart.

The tocotransducer responds to pressure exerted by uterine contractions and simultaneously records the duration and frequency of the contractions.

Tracings of fetal heart rate (FHR) and uterine contraction data are recorded onto the same printout paper.

External fetal monitoring may be used for most women, especially those with a high-risk pregnancy or oxytocin-induced labor.

Electronic fetal monitor and manufacturer’s operating manual

Ultrasound transducer

Tocotransducer

Conductive gel

Transducer straps

Damp cloth

Printout paper

After reviewing the operating manual, prepare the machine for use.

Label the monitoring strip with, or enter into the computer, the patient’s identification number or birth date, her name, the date, maternal vital signs and position, the paper speed, and the number of the strip paper.

Explain the procedure to the patient and make sure she has signed a consent form, if required by the facility.

Wash your hands.

Provide privacy.

Assist the patient to the semi-Fowler or left-lateral position with her abdomen exposed, and palpate the abdomen to locate
the fundus—the area of greatest muscle density in the uterus.

Using transducer straps or a stockinette binder, secure the tocotransducer over the fundus. (See Applying external monitoring devices, page 202.)