Internal Spiral Electrode during Pushing

[nkochrn, RN]

I've had a couple deliveries lately where an internal spiral electrode was placed on baby during labor and then while the mom was pushing the heart rate drops into the 30's. Babies have THANFULLY been completely fine without any signs of distress following birth. I did notice that while the doctor was doing her vag exam the internal was not picking up a heart rate. The baby last night did have variable decels to the 90's following the epidural placement, but after turning, 02, ephedrine, bolus, and stopping pit the baby did recover and did fine throughout labor until pushing, there was no nuchal cord, but baby was a tight fit in the pelvis, mom pushed for only 15 minutes and baby had the biggest cone head I've ever seen.

I was wondering if it's reliable at all to use the internal while the mom is actually pushing???

[RNLaborNurse4U]

If anything, an FSE is the MOST reliable method of determining FHR during pushing. You have a continuous tracing of the FHR. Decels during pushing is completely normal from head compression d/t vagus nerve stimulation on the presenting part.