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· Invasive monitoring (e.g. fetal scalp electrodes) markedly increases the risk of neonatal infection compared with external monitoring however if fetal scalp monitoring is indicated it may be
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· Kendall™ Fetal Scalp Spiral Electrode (FSE) System is an internal monitoring system that measures fetal heart rate. The flexible guide tube can be gently shaped to ease insertion.
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The direct fetal scalp electrode (FSE) is the most accurate way to assess fetal heart rate (FHR) but is invasive and should not be used unless the cervix is at least 2 centimeters dilated and the membranes ruptured (Simpson Creehan 2021).
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· Fetal scalp electrode. 1.12.7 Do not use a fetal scalp electrode for fetal heart rate monitoring if the woman is less than 34 0 weeks pregnant unless all of the following apply it is not possible to monitor the fetal heart rate using either external cardiotocography or intermittent auscultation.
Get PriceIntrapartum Fetal Monitoring GuidelinePhysiological CTG
· FBS Fetal Scalp Blood sample FH Fetal Heart FHR Fetal Heart Rate FIGO International Federation of Gynaecology and Obstetrics FSE Fetal Scalp Electrode FSS Fetal Scalp Stimulation GCP Good Clinical Practice IA Intermittent Auscultation IUGR Intra-Uterine Growth Restriction MAS Meconium Aspiration Syndrome
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Data are limited on use of fetal scalp electrodes in labor in women receiving suppressive antiretroviral therapy who have undetectable viral loads therefore routine use of fetal scalp electrodes for fetal monitoring generally should be avoided in the setting of maternal HIV infection regardless of maternal viral suppression status.
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· Fetal scalp electrode. 1.12.7 Do not use a fetal scalp electrode for fetal heart rate monitoring if the woman is less than 34 0 weeks pregnant unless all of the following apply it is not possible to monitor the fetal heart rate using either external cardiotocography or intermittent auscultation.
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· Kendall™ Fetal Scalp Spiral Electrode (FSE) System is an internal monitoring system that measures fetal heart rate. The flexible guide tube can be gently shaped to ease insertion.
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· the use of a fetal scalp electrode . mobility/skeletal issues that may prevent leaving the bath when necessary. known HIV positive Hepatitis B or Hepatitis C. BMI over 35kg/m2 at term. women who have received narcotic analgesia in the last 4 hours (or are still affected by same). Nitrous oxide and oxygen may be used for pain management for
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· to 34 weeks of gestation because of the risk of fetal intraventricular hemorrhage. • Prior scalp sampling or multiple attempts at fetal scalp electrode placement are also relative contraindications to vacuum extraction since these procedures may increase the risk of cephalohematoma or external bleeding from the scalp wound.
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· The application of a fetal scalp electrode (FSE) is recommended in the second stage of labour. Assessment of fetal well-being by observation of fetal tone colour and pulsation of the umbilical cord is not appropriate and likely to prove inaccurate. Delivery of the buttocks to delivery of the umbilicus should be no longer than 2 minutes.
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· d No contraindication for scalp electrode d First stage no active or involuntary pushing at onset After start-up d Normal ECG waveform with sufficient signal quality d Event log message baseline determined d Check for reactivity and nondeteriorating fetal state at the onset of a STAN recording classify FHR Amer-Wahlin et al.
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· Fetal scalp stimulation. 1.10.38 If the cardiotocograph trace is pathological (see recommendation 1.10.27) offer digital fetal scalp stimulation. If this leads to an acceleration in fetal heart rate only continue with fetal blood sampling if the cardiotocograph trace is still pathological. 2017
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· Contraindications The electrode should NOT be applied to a malpresentation when placenta previa or excessive vaginal bleeding is present when genital infections (e.g. herpes Group B strep gonorrhea) or blood borne diseases (e.g. Hepatitis B carrier HIV carrier) exist or when it is not possible to identify the fetal presenting part.
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The incidence of scalp abscess after placement of a spiral fetal scalp electrode (i.e. the type used since the early 1970s) ranged from 0.1 to 1.0 in retrospective studies of approximately 18 000 neonates. 46 Prospective studies have reported incidences between 0.6 48 and 4.5 . 49. Reports of predisposing factors are conflicting.
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· Fetal scalp electrode was used in 37 492 (22 ) of deliveries. In non-operative vaginal delivery fetal scalp electrode was associated with increased risk of injury to scalp due to birth trauma (1.2 versus 0.9 adjusted odds ratios 1.62 95 confidence intervals 1.41–1.86) and cephalohaematoma (1.0 versus 0.9 adjusted odds ratios 1.57 95 confidence intervals 1.36–1.83).
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· to 34 weeks of gestation because of the risk of fetal intraventricular hemorrhage. • Prior scalp sampling or multiple attempts at fetal scalp electrode placement are also relative contraindications to vacuum extraction since these procedures may increase the risk of cephalohematoma or external bleeding from the scalp wound.
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· o The fetal scalp electrode should NOT be used to rupture membranes if artificial rupture of membranes (ARM) is indicated to commence ST analysis use an amnihook . Suspicion of fetal bleeding disorder. Prior to established labour. Any contraindication to vaginal examination e.g. placenta praevia Woman declines its use.
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· Amniotomy is a procedure usually used to augment or stimulate labor and may result from placement of a fetal spiral electrode. Aminotomy is not risk free. Prolapse of the umbilical cord significant umbilical cord compression and rupture of a vasa previa are some of the potential consequences of an amniotomy that may require emergency intervention.
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· Kendall™ Fetal Scalp Spiral Electrode (FSE) System is an internal monitoring system that measures fetal heart rate. The flexible guide tube can be gently shaped to ease insertion.
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· Fetal EGG and fetal heart rate (FUR) are measured continuously via a scalp or spiral electrode placed on the fetal vertex and connected via a legplate connecting cable to the PIB. The legplate includes a connection for a skin electrode to be placed on the maternal thigh. This electrode provides a reference which is essential in ob-
Get PriceAmniotomy and Placement of Internal Fetal Spiral Electrode
· Amniotomy is a procedure usually used to augment or stimulate labor and may result from placement of a fetal spiral electrode. Aminotomy is not risk free. Prolapse of the umbilical cord significant umbilical cord compression and rupture of a vasa previa are some of the potential consequences of an amniotomy that may require emergency intervention.
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· Fetal predisposition to fractures (e.g. osteogenesis imperfecta). There may be considerable risk if the head has to be delivered from low in the pelvis at a difficult second stage caesarean section. Avoid difficult deliveries (e.g. Trial) in cases of maternal infection (e.g. Hepatitis B/C HIV) as there may be an increased risk of fetal
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· to 34 weeks of gestation because of the risk of fetal intraventricular hemorrhage. • Prior scalp sampling or multiple attempts at fetal scalp electrode placement are also relative contraindications to vacuum extraction since these procedures may increase the risk of cephalohematoma or external bleeding from the scalp wound.
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About the JOGC The Journal of Obstetrics and Gynaecology Canada (JOGC) publishes original research reviews case reports and commentaries by Canadian and international authors pertinent to readers in Canada and around the world. The Journal covers a wide range of topics in obstetrics and gynaecology and women s health covering all life stages including the evidence-based Clinical
Get PriceRecommendations Preterm labour and birth Guidance NICE
· Fetal scalp electrode 1.12.7 Do not use a fetal scalp electrode for fetal heart rate monitoring if the woman is less than 34 0 weeks pregnant unless all of the following apply it is not possible to monitor the fetal heart rate using either external cardiotocography or intermittent auscultation
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Fetal scalp blood sampling. Sampling capillary blood from the fetal scalp during labor of pregnancy in order to determine its pH was introduced to obstetric care in the late 1960s. Despite current skepticism surrounding its utility most notably in the US fetal-scalp blood sampling (FSBS) is still considered a useful fetal monitoring test by
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· Internal FHR monitoring using a fetal electrode (usually known as scalp electrode but it can also be applied to the breech) evaluates the time intervals between successive heart beats by identifying R waves on the fetal electrocardiogram QRS complex and therefore measures ventricular depolarization cycles. This method provides a more accurate
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