Fetal monitoring

gypsyatheart · Feb 20, 2004

Do you consider it appropriate to use the internal fetal monitor when mom is positive for Hep C? I suppose I could add Hep B or HIV to that, anything with blood-born pathogens.

Both the ISE and the IUPC are one time use only. Only the cables are re-used so there is really no reason why we don't use internals on these moms. We have to go by universal precautions anyway because we don't always know the status of every individual.

Mimi2RN, ASN, RN · Feb 20, 2004

I'm thinking of using the monitor with the scalp electrode. I'm more concerned with the break in the baby's skin, increasing the possibility of transmission. We don't give meds without a thorough cleaning, after the baby is born.

BETSRN · Feb 20, 2004

If at all possible it is always better NOT to use the more invasive FSE's and IUPC's. If you are hearing the heartbeat well and it is tracing, why go for an FSE? There is little if any reason to use an IUPC at all unless the patiet is going hours and hours without making cervical change.

regarding diseases processes, it is always better not to use a FSE if possible. It breaks the skin integrity.

SmilingBluEyes · Feb 20, 2004

I agree with Betsy 100%.....least invasive is always best in ALL cases, whether the presence of illness is known, or not. Realistically, we never know for SURE who is infected with HIV or Hepatitis or not, anyhow. I do NOT place internal monitors unless medical necessity makes it critical. In the case of CONFIRMED Hepatitis or HIV, I would NOT place an FSE.

gypsyatheart · Feb 20, 2004

There certainly are times when using internals, be it an IUPC or ISE is necessary. This is not done lightly, however. There is usually something going on to warrant placement of internals, but they definitely have their palce. Depending on your pt population, many times you never even know the status of a lot of these moms. However, if you have someone positive for Hepatitis or HIV, I doubt we would use internals, unless medically emergent. The risks and benefits definitely would need to be weighed and mom would have to be made aware of both.

Mimi2RN, ASN, RN · Feb 21, 2004

The baby did have the fetal monitor electrode.........and the mom had been diagnosed as positive for Hep C. That's why I asked the question....somebody wasn't thinking. I didn't think it was the thing to do (I care for the babies).

Dayray, RN · Feb 21, 2004

I wouldent use an FSE on a Hep or Hiv patient.

As for the use of internals, I try to avoid it alough where I work they are prevelent.