Scalp Lead Placement

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Ineffective external monitoring or inadequate fetal tracing
  • Inadequate staffing for provision of intermittent auscultation
  • Nonreassuring fetal heart rate patterns
CONTRAINDICATIONS
  • Nonreassuring fetal status mandating emergent delivery
  • Nonvertex presentation
  • Patient refusal/uncooperative patient
  • Active maternal hepatitis C, HIV, or transmissible blood infection
  • Placenta previa
  • Vasa previa
  • Untreated group B streptococcus (GBS) infection
  • Fetal head not fully engaged in the maternal pelvis (membranes may rupture when FSE is applied, and the possibility of prolapsed cord cannot be excluded)
  • Inadequate cervical dilation to allow safe placement of FSE
  • Imminent delivery (relative contraindication)
EQUIPMENT
  • Scalp electrode (FSE)
  • Fetal monitor
  • Sterile gloves
  • Connecting wires between FSE and electronic monitor
  • Surgical lubricant or Betadine solution
ANATOMY

Fetal Skull

  • Anterior fontanelle: at the junction of the two frontal bones and the two parietal bones
  • Posterior fontanelle: lies at the junction of the two parietal bones and the occipital bone

Fetal Presentation

  • Vertex presentation: cephalic presentation

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Advise the patient not to make sudden position changes or to attempt to get out of bed without asking the hospital staff to disconnect the wire leads for the FSE.
COMPLICATIONS
  • Fetal scalp abscess
  • Meningitis, CSF leak, or infection if an FSE is applied on a fontanelle
  • Cephalhematoma or subcutaneous scalp emphysema if vacuum extraction is performed
  • Fetal trauma if FSE is placed incorrectly or is applied in nonvertex positions
  • Umbilical cord prolapse
  • Increased risk of neonatal group B streptococcal (GBS) sepsis
  • Puncture injury to the clinician applying the FSE
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