ECG electrodes can cause complications when a mother is given contact with her new-born baby following Caesarean section, doctors have reported.
The electrodes should be placed where no contact is possible with the new-born to eliminate the baby’s cardiac electric activity merging with the mother’s, anaesthetists have warned.
Correspondence published last night (7 November 2019) in the European Journal of Anaesthesiology has revealed that allowing skin-to-skin contact for mother and baby in the operating room, following a Caesarean section birth, led to potential problems in two cases.
In the first, alarms were raised after a 37-year-old woman, who had a C-section to deliver her first child at La Zarzuela University Hospital, Madrid, Spain, displayed signs of dramatically increased heart rate after her son was placed on her chest for early SSC.
Report co-author Dr Nicolas Brogly, of La Zarzuela University Hospital and La Paz Hospital, said the woman remained conscious and other vital signs were normal. The problem was found with the positioning of the electrocardiographic (ECG) electrodes.
“The new-born was found suckling the right electrode of the ECG, which was immediately replaced to another site on the mother’s skin,” said Dr Brogly. “The abnormal ECG rhythm, which was in fact a combination of the mother and the baby’s ECG, then disappeared.”
In the second case, involving a 36-year-old who was delivering her second child at St Antonius Hospital, Woerden, the Netherlands, the ECG changed to tachycardia when the baby was placed on her chest and it appeared to contain two different ECG rhythms in one recording.
The new-born was found to have taken the right ECG lead in his hand and when the lead was moved to the mother’s right shoulder, the ECG returned to normal.
Dr Brogly said: “Both of these cases show that through the baby suckling or touching an ECG electrode, the cardiac electric activity of the baby can merge with the mother’s…this novel source of electric interference represents a risk for both the mother and the baby.
“The alarm on the monitor could have led to a misdiagnosis with of supraventricular arrhythmia, which could then have led to administration of antiarrhythmic drugs, or even worse, using the defibrillator on the mother to stabilise her heart rate.”
The authors conclude: “When planning SSC in the operating room, we recommend ECG electrodes should be placed where no contact will be possible with the new baby (at the back of the shoulders for example) to allow cardiac monitoring of the mother while avoiding ECG interference with the child upon skin contact after delivery.”
Brogly N, Siegers L, Schyns-van den Berg A et al. Skin-to-skin contact during caesarean delivery – correspondence. European Journal of Anaesthesiology 7 November 2019; doi:10.1097/EJA.0000000000001107
https://journals.lww.com/ejanaesthesiology/pages/default.aspx
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