Name of the Procedure:

Fetal Scalp Blood Sampling (FSBS)

Summary

Fetal scalp blood sampling is a diagnostic procedure performed during labor to assess the baby's well-being. It involves taking a small blood sample from the baby's scalp through the cervix to measure the levels of oxygen and other chemicals.

Purpose

FSBS is used to evaluate fetal distress or low oxygen levels during labor. The goal is to determine if the baby is receiving enough oxygen or if interventions such as an emergency delivery are necessary to prevent complications that can arise from prolonged oxygen deprivation.

Indications

• Non-reassuring fetal heart rate patterns
• Abnormal results from other fetal monitoring techniques (e.g., electronic fetal monitoring)
• Suspected fetal acidosis
• Concerns about the baby's oxygenation during labor

Preparation

• Patient may need to empty their bladder before the procedure.
• Explanation of the procedure and its necessity to the patient.
• Routine monitoring of fetal heart rate and contractions.
• No specific dietary restrictions or fasting required.

Procedure Description

1. The mother is positioned comfortably, usually in a semi-reclined position.
2. A vaginal speculum is inserted to visualize the cervix.
3. An amnioscope or a similar instrument is used to access the fetal scalp.
4. The healthcare provider cleans the area on the fetal scalp with a sterile solution.
5. A small incision is made on the fetal scalp, and a capillary tube collects the blood sample.
6. The blood sample is then analyzed for pH, lactate, and blood gas levels to assess oxygenation.

Tools used include a vaginal speculum, an amnioscope, a lancet for making the incision, and a capillary tube. Typically, no anesthesia or sedation is required, as the procedure is relatively quick and the cervix is already dilated during labor.

Duration

The procedure usually takes about 10-20 minutes.

Setting

FSBS is performed in a hospital labor and delivery room.

Personnel

• Obstetrician or a trained midwife
• Labor and delivery nurse
• Medical technologist (for blood sample analysis)

Risks and Complications

• Minor bleeding at the site of the scalp incision
• Infection at the incision site
• Discomfort or pain for the mother
• Rarely, complications related to incorrect sampling

Benefits

• Provides critical information about the baby's oxygenation status during labor
• Helps determine the necessity for immediate interventions, potentially preventing neonatal complications

Recovery

• Post-procedure, monitoring of fetal heart rate continues.
• No specific recovery is needed for the mother; she can continue with the labor process as planned.

Alternatives

• Continuous electronic fetal monitoring: Less invasive, but may not provide specific information about blood chemistry.
• Fetal pulse oximetry: Measures oxygen levels through a sensor placed on the baby's head, less commonly used.
• Immediate delivery: May be considered if fetal distress is strongly suspected without further diagnostics.

Patient Experience

• The mother might feel pressure or mild discomfort during the insertion of the instruments.
• Pain is generally minimal and manageable.
• Support from healthcare providers is essential to ensure comfort and reassurance during the procedure.
• Pain relief options, if necessary, will be discussed with the patient.