A randomized controlled trial to compare three types of fetal scalp electrode.
OBJECTIVE
To compare three scalp electrodes in respect of need for reapplication, trace quality and scalp trauma.


METHODS
Randomized controlled trial.


METHODS
Maternity Unit, Royal Berkshire Hospital, Reading.


METHODS
780 women in labour at term, with cephalic fetal presentation, deemed to require electronic fetal heart rate monitoring using a scalp electrode.


METHODS
Three types of fetal scalp electrode: Rocket-Rolon (double-helix spiral); Hewlett-Packard (double-helix spiral); and Surgicraft-Copeland (clip).


METHODS
Need for more than one electrode; reason for replacement; trace quality; scalp trauma; direct financial costs.


RESULTS
Reapplication was significantly least likely in the Surgicraft-Copeland group (odds ratio vs Hewlett-Packard = 0.61, 95% CI 0.41-0.90; odds ratio vs Rocket-Rolon = 0.43, 95% CI = 0.29-0.62). This reflected a much lower rate of replacement because of detachment. The Hewlett-Packard was, however, least likely to be replaced because of poor trace quality. Interpretable traces were equally common, but trace quality tended to be superior in the Hewlett-Packard group. There was no serious scalp trauma. Difficulty removing the electrode was least often reported in the Hewlett-Packard group, and a mark on the scalp persisted least often in the Rocket-Rolon group.


CONCLUSIONS
The Surgicraft-Copeland performed the best overall, and particularly in respect of attachment to the scalp. It appears to be the electrode of choice of the three tested.
Needs
L
L
Maternity Unit, Royal Berkshire Hospital, Reading.
Grant
A
A
Sleep
J
J
Ayers
S
S
Henson
G
G
D000328:Adult; D004566:Electrodes; D005260:Female; D005323:Fetal Monitoring / Q000295:instrumentation*; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D012535:Scalp / Q000293:injuries