A fetal scalp electrode or FSE is a spiral wire that can be placed on the scalp of the fetus to monitor their heart rate
A fetal scalp electrode or FSE is a spiral wire that can be placed on the scalp of the fetus to monitor their heart rate

A fetal scalp electrode or FSE is a spiral wire that can be placed on the scalp of the fetus to monitor their heart rate and ensure their well-being. Placing a fetal scalp electrode is a crucial part of directly monitoring the fetus inside the womb (internal fetal monitoring). This helps in the evaluation of fetal heart rate as well as the variations in the fetal heartbeat, particularly regarding the contractions of the uterus during labor. The doctor measures the strength and duration of uterine contractions during labor and correlates them with the fetal heart rate and pattern. This allows the doctor to know whether the baby is having any distress.

The wire of the scalp electrode runs from the scalp of the baby to the mother’s cervix. The readings can be seen on a monitor to which the wire of the electrode is connected. A scalp electrode provides accurate reading, which does not get affected by factors like movement. The electrode can only be placed when the bag of water (amniotic sac) around the baby has broken and the cervix is dilated (opened). Internal fetal monitoring allows the doctor to closely monitor the baby during labor.

Your provider may use internal monitoring when external monitoring is not giving a good reading, or your provider may use this method to watch your baby more closely during labor. It is a more accurate assessment as compared to the assessment of the fetal heart rate through the mother’s abdomen (external fetal monitoring).

How is a fetal scalp electrode placed?

A fetal scalp electrode is placed for internal fetal monitoring, which is generally done when the patient is in labor. The doctor will explain the procedure and take the patient’s consent. The patient will be asked to wear a hospital gown before the procedure. During the procedure:

  • The patient will lie on a labor bed with their feet and legs supported like in a pelvic examination.
  • The healthcare provider will perform a vaginal exam with a gloved hand to know how much the cervix has dilated.
  • If the amniotic sac is not broken, the provider will break open the membranes with a tool.
  • The healthcare provider will then feel the part near the cervix (the presenting part), which is usually the baby’s head.
  • A thin tube called a catheter is inserted in the vagina. The catheter is attached to a small wire (the electrode).
  • The catheter is finally removed leaving the electrode on the baby’s scalp for monitoring.

Can a fetal scalp electrode harm the baby?

Fetal scalp electrode placement is a relatively safe procedure that does not use any sharp instruments or radiations. There may, however, be an increased risk of infections, injury, and bruising of the baby’s scalp or other body parts. Internal fetal monitoring should not be done if the mother has HIV infection since it may be transmitted to the baby during the procedure.

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Medically Reviewed on 11/11/2020
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899296/#:~:text=Introduction,is%20difficult%20to%20time%20accurately.

https://www.stanfordchildrens.org/en/topic/default?id=external-and-internal-heart-rate-monitoring-of-the-fetus-92-P07776