<prompt> Answer this question truthfullyWhat method can be used to determine the fetal heart rate if it cannot be confirmed using external methods?  <response>: <reason> If the fetal heart rate cannot be confirmed using external methods, such as a Doppler ultrasound or a fetoscope, a fetal scalp electrode can be used to determine the heart rate. This involves attaching a small electrode to the scalp of the baby, which can measure the electrical activity of the fetal heart. While this method is more invasive than external methods, it can provide a more accurate measurement of the fetal heart rate, especially in cases where external methods are not effective or there is concern about the accuracy of the measurement. The use of a fetal scalp electrode is typically reserved for situations where continuous monitoring of the fetal heart rate is necessary, such as during labor and delivery. 