Intrauterine Pressure Catheter for Fetal Monitoring

An intrauterine pressure catheter (IUPC) is a small flexible tube that is inserted into the uterus, lying between the baby and the uterine wall, making it a form of internal monitoring for contractions. It provides exact measurements of contractions, unlike external monitors.

When an Intrauterine Pressure Catheter Is Used

The IUPC is used when labor is progressing slowly or is stalling to assess that the contractions are strong enough but not too strong by looking at the intrauterine pressure (IUP). Once it is used, it is typically left in place for the duration of your labor and is attached to your leg to secure it.

Your water must be broken to use the intrauterine pressure catheter. If it has not broken, your doctor or midwife will perform an amniotomy to break it. It is more frequently used with inductions of labor and with the use of ​Pitocin. It may also be used in conjunction with a fetal scalp electrode for internal monitoring of your baby's heart rate. It can also be used when other forms of monitoring are not adequate for a variety of reasons.

Examples: My doctor wanted me to have an intrauterine pressure catheter to make sure that the Pitocin wasn't too strong.

Risks

It was believed that if we could monitor the intrauterine pressure that we would be able to predict when to intervene and prevent harm to the mother or baby in labor. The studies that have been done have largely concluded that IUPCs are more likely to be used when labor is longer, when the gestational age is longer, and when the mothers are older. But they have not really changed the outcomes for moms and babies in terms of the number of cesarean sections, vacuum extractions, or forceps deliveries done. Though, it is interesting to note that when you use the fetal scalp electrode alone, you have a higher incidence of vaginal delivery than when it is used in conjunction with the IUPC.

What we have seen is that the incidence of maternal fever goes up when we use the IUPC. When a mother gets a fever in labor, that often starts its own cascade of interventions. This can lead to a workup in the nursery for the baby, including separation and antibiotics, which may interfere with bonding, breastfeeding, and recovery.

The use of an intrauterine pressure catheter should be weighed with the perceived benefits against the potential risks when deciding if this is a viable alternative for your labor. Be sure to talk to your doctor about the alternatives to using this device and what information will be gained with its use. It is not right for all labors, nor is it right for all laboring people.

This is a decision that you and your practitioner will decide together. It is also important to note that even if you had an IUPC with previous labor, it does not mean that you would need one in future labors.