Iowa Neonatology Handbook: Infection

Scalp Abscess

Herman A. Hein, MD
Peer Review Status: Internally Peer Reviewed

I. Electronic Tracing

Electronic fetal heart rate monitoring has become an integral part of high risk obstetric management. Nearly one-half of the infants born at University Hospitals are presently monitored with an in-utero spiral electrode applied to the scalp or other presenting part.

II. Complications

A. A complication of this type of fetal monitoring, recognized in less than 1% of these infants during hospitalization, is the development of an abscess at the site of the electrode attachment. Microbiology reflects contamination by vaginal bacterial flora (predominantly anaerobes, occasional strep and gram negatives, and not staph aureus). If the infant is clinically ill, cultures should be obtained and the usual systemic antibiotics should be given providing the results of the cultures. If the infant is clinically well, the primary therapeutic modality is incision and drainage, followed by local wound care.

B. Parental instruction in wound care and precautions as well as local physician follow-up remain integral to successful management.

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