Equipment
Equipment used in intrauterine pressure catheter placement is as follows:
-
Sterile gloves
-
Intrauterine pressure catheter (see image below)
-
Intrauterine pressure catheter cable (see image below)
-
Labor monitoring equipment (see image below)
Patient Preparation
Anesthesia
No anesthesia is required for intrauterine pressure catheter placement. Patients usually experience only slightly more discomfort than that associated with cervical examination alone.
Positioning
Intrauterine pressure catheter placement is most easily accomplished in the supine, frog-leg position. However, any position in which the provider and patient are comfortable with the procedure is acceptable, including lateral and knee-chest.
Monitoring & Follow-up
Overall, complications of intrauterine pressure catheter placement are uncommon.
The most serious risks are associated with extraovular catheter placement. Several case reports have described placental abruption, [5] placental laceration, and laceration of a fetal placental vessel [6] requiring emergent cesarean delivery following intrauterine pressure catheter insertion. Each of these cases described fetal heart rate changes, including decelerations and bradycardia, within several minutes of intrauterine pressure catheter insertion. These complications highlight the importance of verifying intraamniotic placement of the catheter and carefully monitoring the fetal heart rate tracing following insertion. Introduction of a foreign body also increases the risk of intraamniotic infection. [7]
In an observational study of 16,887 women who had a cesarean delivery, intrapartum placement of an intrauterine pressure catheter was associated with a greater risk of post-cesarean surgical site infections. [8]
-
IUPC tracing
-
An intrauterine pressure catheter and cable.
-
An example of a fetal heart rate and contraction monitor.
