Fetal complications after placement of an intrauterine pressure catheter: a report of two cases and review of the literature.
BACKGROUND
Uterine contractions during labor can be monitored by external tocodynamometry or by the use of an intrauterine pressure catheter (IUPC). Since an IUPC measures the frequency of contractions as well as their strength and duration, it is thought to be more accurate than external tocodynamometry. However, limited evidence on this subject suggests that IUPC may not improve maternal or perinatal outcomes. Moreover, the use of IUPC may cause fetal complications.


METHODS
We describe the placement of an IUPC during induction of labor with oxytocin in two cases, one presenting with a singleton pregnancy and the other a twin pregnancy. After introduction of the IUPC, both cases were complicated by blood loss and signs of fetal distress on cardiotocography. An emergency cesarean section was performed in both cases. In the first case, extramembranous placement of the IUPC was observed, whereas in the second case, the IUPC had lacerated an arteriovenous anastomosis in the membranes, resulting in perinatal death.


CONCLUSIONS
Placement of an intrauterine pressure catheter instead of external tocodynamometry has a small risk for serious fetal complications.
Wilmink
Freke A
FA
Department of Obstetrics and Gynecology, Amphia Hospital Breda, Breda, The Netherlands.
Wilms
Femke F
FF
Heydanus
Roger
R
Mol
Ben W J
BW
Papatsonis
Dimitri N M
DN
D000328:Adult; D002404:Catheterization / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005316:Fetal Distress / Q000209:etiology*; D005323:Fetal Monitoring / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D019300:Medical Errors