Eyelid Laceration in a Neonate by Fetal Monitoring Spiral Electrode

Lauer, Andreas K.; Rimmer, Steven

doi:10.1016/s0002-9394(98)00035-x

Cited by 16 publications

(1 citation statement)

References 2 publications

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“…Two previous cases of ocular adnexal injury by an FSE have been reported in ophthalmology literature. The first involved a neonate with an FSE that was inadvertently placed on the left upper eyelid during labor and avulsed by its own weight during caesarean section; further ocular examination identified superficial eyelid lacerations but no globe injury [ 10 ]. The second report detailed a case in which the FSE was placed on the right eye, and further examination found that the FSE had penetrated the inferior sclera and torn the peripheral retina [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Neonatal eyelid penetration from insertion of a fetal scalp electrode: a case report

Cheng

Laurenti

Kurup

2022

BMC Pregnancy Childbirth

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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. Case presentation 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. Conclusion 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.

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Section: Discussionmentioning

confidence: 99%