title: Neonatal complications associated with use of fetal scalp electrode: a retrospective study.
abstract: OBJECTIVE
  To estimate the incidence and risk of complications associated with a fetal scalp electrode and to determine whether its application in the setting of operative vaginal delivery was associated with increased neonatal morbidity.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Twelve clinical centers with 19 hospitals across nine American Congress of Obstetricians and Gynecologists US districts.
  
  
  METHODS
  Women in the USA.
  
  
  METHODS
  We evaluated 171 698 women with singleton deliveries ≥ 23 weeks of gestation in a secondary analysis of the Consortium on Safe Labor study between 2002 and 2008, after excluding conditions that precluded fetal scalp electrode application such as prelabour caesarean delivery. Secondary analysis limited to operative vaginal deliveries ≥ 34 weeks of gestation was also performed.
  
  
  METHODS
  Incidences and adjusted odds ratios with 95% confidence intervals of neonatal complications were calculated, controlling for maternal characteristics, delivery mode and pregnancy complications.
  
  
  RESULTS
  Fetal scalp electrode was used in 37 492 (22%) of deliveries. In non-operative vaginal delivery, fetal scalp electrode was associated with increased risk of injury to scalp due to birth trauma (1.2% versus 0.9%; adjusted odds ratios 1.62; 95% confidence intervals 1.41-1.86) and cephalohaematoma (1.0% versus 0.9%; adjusted odds ratios 1.57; 95% confidence intervals 1.36-1.83). Neonatal complications were not significantly different comparing fetal scalp electrode with vacuum-assisted vaginal delivery and vacuum-assisted vaginal delivery alone or comparing fetal scalp electrode with forceps-assisted vaginal delivery and forceps-assisted vaginal delivery alone.
  
  
  CONCLUSIONS
  We found increased neonatal morbidity with fetal scalp electrode though the absolute risk was very low. It is possible that these findings reflect an underlying indication for its use. Our findings support the use of fetal scalp electrodes when clinically indicated.
  
  
  CONCLUSIONS
  Neonatal risks associated with fetal scalp electrode use were low (injury to scalp 1.2% and cephalohaematoma 1.0%).
authors.affiliation: Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA. tetsuya.x.kawakita@gunet.georgetown.edu.
authors.forename: T
authors.initials: T
authors.lastname: Kawakita
authors.affiliation: Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: U M
authors.initials: UM
authors.lastname: Reddy
authors.affiliation: Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, DC, USA.
authors.forename: H J
authors.initials: HJ
authors.lastname: Landy
authors.affiliation: Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Iqbal
authors.affiliation: Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, MD, USA.
authors.forename: C-C
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Grantz
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology*; D015148:Cardiotocography / Q000009:adverse effects / Q000295:instrumentation*; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D004566:Electrodes / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D012189:Retrospective Studies; D012535:Scalp / Q000196:embryology / Q000293:injuries*; D014481:United States / Q000453:epidemiology
keywords: Cephalohaematoma; fetal scalp electrode; scalp injury