Complications of fetal scalp electrode placement: a case report, literature review and summary of case reports

A case of severe scalp laceration due to a scalp electrode in our hospital prompted us to review the available literature on this matter. Roughly three categories of adverse effects due to scalp electrodes can be distinguished: common minor skin lesions (41% of cases of electrode application), scalp abscesses (0.1–4.5%) and rarer, sometimes major, complications only described in case reports. We present a complete overview of published case reports. A recently published Cochrane review on the effectiveness of continuous fetal heart rate monitoring sheds doubt on the benefits of continuous monitoring over intermittent auscultation. Reported complications, considering this controversy regarding the benefits, should prompt clinicians to reconsider at what threshold the benefits of scalp electrode placement outweigh its risks.