Scalp Lead Placement

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  • Ineffective external monitoring or inadequate fetal tracing
  • Inadequate staffing for provision of intermittent auscultation
  • Nonreassuring fetal heart rate patterns
  • 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)
  • Scalp electrode (FSE)
  • Fetal monitor
  • Sterile gloves
  • Connecting wires between FSE and electronic monitor
  • Surgical lubricant or Betadine solution

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

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

  • 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.
  • 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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