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Pregnancy Bliss | Reproductive Health Hub

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Monitoring the second twin in labour

If the second twin shows features of distress, how can one gain access to it to take a blood sample for analysis?
It is not possible. If a CTG shows worrying features for Twin 2, the only solution is to perform a caesarean section and deliver them. Quite often it turns out to have been a false scare but most people will agree that it is better to be safe than sorry.

What is a fetal scalp electrode?
Part of the failings of the conventional CTG is the weakness inherent in monitoring the fetal heart remotely, with the probe on the maternal abdomen. It is not unusual to pick it erratically or sometimes not at all. Sometimes one ends up with the maternal heartbeat.

A fetal scalp electrode (FSE) is a simple device, which is a significant improvement on this state of affairs. The small probe is attached to the skin of the baby’s scalp and it directly monitors the heartbeat. It is more accurate and more reliable.

With twins, it is normal practice to monitor Twin 1 with a scalp electrode and Twin 2 with an abdominal transducer. Of course, calling it "scalp" electrode is a slightly restrictive term. In breech presentation, the electrode can be placed on the fetal buttocks and it functions as usual. Having said that, labour where the first twin is leading with a breech is quite unusual. Such twins are usually delivered by caesarean section.

Last update: March 11, 2013

CTG trace

A fetal scalp electrode monitors the baby’s heart rate and pattern directly rather than through the mother’s abdomen. It is, therefore, more reliable. With a twin pregnancy, the electrode will monitor the first (leading) twin while the second twin is monitored through the abdomen

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