Neonatal scalp abscess and fetal monitoring: factors associated with infection.

Forty-two of 929 (4.5 per cent) newborn infants prospectively studied following continuous, direct fetal heart rate monitoring during labor developed a scalp abscess at the site of electrode application during the neonatal period. Factors associated with infection with the use of a multivariate analysis were duration of monitoring (p less than 0.01) and high-risk indications for monitoring (p less than 0.01). Of the 42 infected neonates, 33 had complete bacteriologic studies. Microorganisms were isolated from all the infection tended to be polymicrobial, most commonly containing both aerobes and anaerobes. Staphylococcus epidermidis, Streptococcus, Peptostreptococcus, and Peptococcus were the predominant isolates. These data indicate that scalp abscess complicating intrapartum fetal monitoring may be nosocomial importance, and infants monitored should be closely observed in order to prevent more serious infectious complications.