Abstract：
BACKGROUND: A fetal scalp electrode (FSE), first described by Edward Hon in 1967, is an intrapartum monitoring device embedded directly into the fetal scalp for an accurate measure of fetal heart rate. Though use of an FSE is generally safe, complications can occur from misplacement, including ophthalmic injury.
METHODS: Patient was a 28-year-old G6P5006 who presented for induction of labor at 39 weeks due to asymptomatic bilateral pulmonary embolism. Concerning findings on external fetal monitoring led to placement of a fetal scalp electrode for close monitoring. Upon delivery, the neonate was noted to have the FSE embedded in the left upper eyelid. Ophthalmology was consulted and could not rule out ocular injury on external examination at the bedside. Examination under anesthesia in the operating room demonstrated no penetration of the ocular globe, and the eyelid laceration was sutured. The laceration was well-healing at one-week follow-up with no further complications.
CONCLUSIONS: Facial or brow presentation during delivery is rare but may increase the risk for misplacement of an FSE. Ultrasound verification of vertex position is warranted immediately prior to placing an FSE for patients at higher risk of facial or brow presentation. Periorbital edema of neonates may protect against damage to deeper structures. However, Ophthalmology should be consulted to rule out ocular injury if the FSE is placed in the periocular region.
METHODS: Patient was a 28-year-old G6P5006 who presented for induction of labor at 39 weeks due to asymptomatic bilateral pulmonary embolism. Concerning findings on external fetal monitoring led to placement of a fetal scalp electrode for close monitoring. Upon delivery, the neonate was noted to have the FSE embedded in the left upper eyelid. Ophthalmology was consulted and could not rule out ocular injury on external examination at the bedside. Examination under anesthesia in the operating room demonstrated no penetration of the ocular globe, and the eyelid laceration was sutured. The laceration was well-healing at one-week follow-up with no further complications.
CONCLUSIONS: Facial or brow presentation during delivery is rare but may increase the risk for misplacement of an FSE. Ultrasound verification of vertex position is warranted immediately prior to placing an FSE for patients at higher risk of facial or brow presentation. Periorbital edema of neonates may protect against damage to deeper structures. However, Ophthalmology should be consulted to rule out ocular injury if the FSE is placed in the periocular region.
摘要：
背景：胎儿头皮电极（FSE），EdwardHon于1967年首次描述，是一种直接嵌入胎儿头皮的产时监测设备，用于精确测量胎儿心率。虽然使用FSE通常是安全的，并发症可能来自错位，包括眼部损伤。
方法：患者是一名28岁的G6P5006患者，由于无症状的双侧肺栓塞，在39周时出现引产。关于外部胎儿监护的发现，导致放置胎儿头皮电极进行密切监护。交付时，注意到新生儿的FSE嵌入在左上眼睑中。咨询眼科，不能排除床边外部检查的眼外伤。手术室麻醉检查显示眼球没有穿透，眼睑裂伤缝合。在一周的随访中，裂伤愈合良好，没有进一步的并发症。
结论：分娩过程中面部或眉毛出现很少，但可能会增加FSE错位的风险。对于面部或眉毛表现风险较高的患者，必须在放置FSE之前立即进行顶点位置的超声验证。新生儿的眶周水肿可以防止对较深结构的损害。然而,如果FSE放置在眼周区域，应咨询眼科以排除眼外伤。
方法：患者是一名28岁的G6P5006患者，由于无症状的双侧肺栓塞，在39周时出现引产。关于外部胎儿监护的发现，导致放置胎儿头皮电极进行密切监护。交付时，注意到新生儿的FSE嵌入在左上眼睑中。咨询眼科，不能排除床边外部检查的眼外伤。手术室麻醉检查显示眼球没有穿透，眼睑裂伤缝合。在一周的随访中，裂伤愈合良好，没有进一步的并发症。
结论：分娩过程中面部或眉毛出现很少，但可能会增加FSE错位的风险。对于面部或眉毛表现风险较高的患者，必须在放置FSE之前立即进行顶点位置的超声验证。新生儿的眶周水肿可以防止对较深结构的损害。然而,如果FSE放置在眼周区域，应咨询眼科以排除眼外伤。
