Scalp Electrode for Fetal Heart Monitoring

by John McKiggan

The scalp electrode can assist fetal heart monitoring

Monitoring of the fetal heart rate during labour has been available to mothers in labour since the 1960s. Physicians and nurses are trained to identify fetuses at risk for complications during labour and delivery and to take whatever steps are necessary to advise the mother of the reasonable treatment options and interventions available to protect her and her baby.

Scalp Electrode Alternative

Frequently, an external monitoring process that uses Doppler ultrasound is used to “listen” to the fetal heart and monitor and record the fetal heart rate. However, in some situations, it is appropriate to use a process which involves applying a scalp electrode to the scalp of the fetus which provides monitoring of the fetal heart, which is similar to an ECG.

Using the internal monitoring method with the fetal scalp electrode is useful where monitoring of the fetal heart is required but other monitoring methods are unreliable or unsatisfactory. The caregivers may feel that obtaining a fetal heart “tracing” or record of the fetal heart rate is not accurate and for a variety of reasons, the external monitor is not providing a reliable tracing. Sometimes babies “hide” and make it difficult to pick up the fetal heart rate, and the tracing actually may document the heart rate of the mother, which is usually much lower than a normal fetus.

This happens most often while the mother is in the second stage of labour – i.e., “pushing,” and the baby is in the birth canal and the ultrasound cannot pick up the heart beat through the bones. The lack of a reliable fetal heart tracing using the external monitor may make the use of an internal fetal scalp electrode an appropriate and recommended option.

Scalp Electrode and Longer Heart Rate Record

The fetal scalp electrode allows a more continuous record of the fetal heart rate, which may be desirable where there is a concern about the well being of the fetus. Sometimes, even when the Doppler ultrasound can pick up the fetus’ heart rate, a fetal scalp electrode will be used to monitor the fetus’ cardiac function in more detail.

The internal monitoring method is only available after the membranes have ruptured and where there are no other contra-indications (such as HIV in the mother or other higher risk situations). In some instances, caregivers may recommend artificial rupture of the membranes in order to make use of internal monitoring with a fetal scalp electrode.

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