ABSTRACT
Intrapartum fetal monitoring has become a standard procedure for the evaluation of fetal well-being during labor. The passage of a mechanical conduit through a non-sterile area and the application of a scalp electrode to the fetal head introduce the potential for augmented fetal infectious morbidity. There is no statistically significant increase in the maternal infectious morbidity. The risks to the mother are basically those inherent in the situation, for example, premature rupture of the fetal membranes and labor or the presence of Neisseria gonorrhoeae or group A streptococci as part of the vaginal flora. The combination of rupture of the membranes and labor, aside from the presence of exogenous pathogens in the vaginal flora, is the major risk factor for both the frequency and the severity of maternal infection. Once the membranes are ruptured, internal monitoring does not appear to add to the risk for the gravida. The scalp electrode per se has created a new infectious complication for the fetus, namely, abscess formation at the site of attachment. The incidence of scalp abscess is of the order of 1:200 to 1:400 monitored patients. While scalp abscesses have been noted with both the clamp-on type and the spiral electrode, spiral electrodes with a barb at the tip may have been associated with a higher incidence. Fortunately these types of spiral electrodes are no longer clinically employed.
