PEDIATRICS Vol. 74 No. 1 July 1984, pp. 81-85
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Septic Dermatitis of the Neonatal Scalp and Maternal Endomyometritis with Intrapartum Internal Fetal Monitoring

Marilyn M. Wagener MPH1, Russell Rule Rycheck MD, DrPH1, Robert B. Yee MD1, Joanne F. McVay MS, MPH1, Carol L. Buffenmyer MSc1, and James H. Harger MD1

1 From the Magee-Womens Hospital, Pittsburgh

During a 3-month period, 1,062 mother-infant pairs were studied for infections following internal fetal monitoring during labor. Six infants (0.56%) developed septic scalp dermatitis at the site of the spiral electrode application. Factors associated with septic scalp dermatitis included the number of vaginal examinations, the use of an intrauterine pressure catheter or of more than one spiral electrode, and fetal scalp blood sampling. Maternal diabetes and endomyometritis were also associated with an increased risk of scalp infection. The duration of spiral electrode use and duration of ruptured membranes were not significant risk factors. Endomyometritis was documented in 41 mothers, an overall incidence of 3.9%. In women whose babies were delivered by cesarean section, the incidence of endomyometritis was 28/117 (23.9%). Using multivariate analysis by logistic regression, endomyometritis was associated with the number of vaginal examinations during labor but not with the duration of internal monitoring, duration of labor, or duration of ruptured membranes.

Key Words: dermatitis • neonatal scalp dermatitis • fetal monitoring • maternal endomyometritis

Submitted on July 14, 1983
Accepted on August 31, 1983