When Should A Fetal Scalp Electrode Be Used?


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When there’s a concern about how well an unborn child will tolerate the labor and delivery process, healthcare providers must be able to monitor the child for any signs of distress. One way they can do this is with a fetal scalp electrode.

What Is A Fetal Scalp Electrode?

When a woman is in labor, the most accurate way to assess whether or not her baby is getting adequate blood flow and oxygen is by monitoring the baby’s heart rate. There are three ways for a healthcare provider to monitor the fetal heart rate. The least reliable method is listening with a special stethoscope or Doppler tool. A more reliable method is electronic fetal monitoring, where a belt-like device is strapped around the mother’s abdomen. The most reliable method is to monitor the baby’s heart rate internally with an electrode attached to the baby’s scalp. However, this can only be done if the mother’s water has broken, she’s at least 2 - 3 centimeters dilated, and the baby is in a favorable position. It’s estimated that around 20 percent of all labors in the United States utilize fetal scalp electrodes.

When Is A Fetal Scalp Electrode Used?

Fetal heart rate monitoring is critical in preventing birth injuries like cerebral palsy. It’s the best way to identify when a baby is distressed and needs medical intervention. In many cases, external monitoring is sufficient to monitor a baby’s well-being, but there are instances where internal monitoring with a fetal scalp monitor would be preferred. They include:

  • maternal obesity, which may limit the effectiveness of an external monitor
  • a need for frequent changes to the mother’s body position, which can cause an external monitor to slip out of position
  • when external monitoring shows that a baby may be experiencing some distress, more accurate monitoring is required

When Should A Fetal Scalp Electrode Be Avoided?

While internal monitoring with a fetal scalp electrode is the most accurate way to measure a baby’s heart rate during labor, there is a risk of complications, including bruising, infection, and bleeding under the scalp or potentially into the brain. Because of these risks, fetal scalp monitoring is only indicated in cases where the potential benefit outweighs any potential risks. Also, there are some pregnancies where using a fetal scalp electrode is too risky, such as in mothers with infectious diseases like HIV, when the baby is not in a good position, and when the placenta is in an unfavorable location.

What Can Happen When A Fetal Scalp Electrode Isn’t Used Appropriately?

When a fetal scalp electrode is indicated but is not used, there is a risk of the baby suffering a life-altering complication during birth that could result in cerebral palsy, developmental delay, learning difficulties, epilepsy, or even death. There’s also a chance that a baby may be assumed to be in distress when it is actually tolerating birth well or perhaps just needs minor interventions like altering the mother’s position or giving her oxygen or IV fluids. In these instances, an emergency C-section may be done unnecessarily, which carries its own set of risks for the mother.

When a fetal scalp electrode is used in cases where it shouldn’t be, the baby is at risk of dangerous bleeding and infections that could become life-threatening. It’s possible that the electrode could be inserted somewhere other than the scalp (such as this case, where the electrode was placed in the baby’s eye, causing permanent blindness).

Why Choose Ross Feller Casey?

If your child has experienced serious complications during labor that resulted in long-term disability or death, then you deserve justice. Whether a doctor neglected to use a fetal scalp electrode when it was indicated or ignored the results when it was used, they could be held responsible for anything that occurred due to their negligence. Likewise, if a fetal scalp electrode was used in a case that wasn’t warranted (or was outright contraindicated), they could also be held negligent for any harm they’ve caused.

The legal team at Ross Feller Casey is ready and waiting to fight for you and your family. Our skilled lawyers and on-staff team of Ivy League-trained doctors understand that every situation is unique and there’s no one-size-fits-all approach to fetal monitoring during labor. We have the resources and experience needed to determine whether medical malpractice played a part in your child’s injury and have an unmatched track record of success when it comes to birth injury lawsuits.

There’s no fee unless you win, and consultations are always free. Contact us today, and let us help you get the justice that you and your family deserve.

Disclaimer: Ross Feller Casey, LLP provides legal advice only after an attorney-client relationship is formed. Our website is an introduction to the firm and does not create a relationship between our attorneys and clients. An attorney-client relationship is formed only after a written agreement is signed by the client and the firm. Because every case is unique, the description of awards and summary of cases successfully handled are not intended to imply or guarantee that same success in other cases. Ross Feller Casey, LLP represents catastrophically injured persons and their families in injury and wrongful death cases, providing legal representation in Pennsylvania and New Jersey.