Maternal-Switching (Maternal Insertion)
Excessive, coupling, hypertonus
Reassuring tracing. The excessive uterine activity should prompt discontinuation of any
The true fetal rate can be confirmed by auscultation or by fetal scalp electrode.
Half-counting, noise, drop out
Reassuring tracing. The half-count at 4-5 minutes into the tracing may simulate a fetal
deceleration, but the abruptness and the lack of any compensatory changes when the
normal rate returns suggests that this is half-counting. Insertion of the maternal heart rate
(see below) may produce a similar pattern. Note also very brief episodes of half-counting,
maternal insertion, and signal drop out.
Auscultation or the application of a direct scalp electrode, if feasible, will reveal the true
fetal heart rate.
11 Monitoring FHR and FMP Using Ultrasound