Intrauterine Pressure Catheter (IUPC)

Intrauterine Pressure Catheter (IUPC)
Intrauterine Pressure Catheter Kit (IUPC). Photo © Robin Elise Weiss

Definition: 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.

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.

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

It was believed that if we could monitor the intrauterine pressure that we would be able to predict when to intervene. 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 c-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 incide 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 it's 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. 

Sources:

Bakker JJ, Janssen PF, van Halem K, van der Goes BY, Papatsonis DN, van der Post JA, Mol BW. Cochrane Database Syst Rev. 2013 Aug 3;8:CD006947. doi: 10.1002/14651858.CD006947.pub3. Internal versus external tocodynamometry during induced or augmented labour.

Bakker JJ, Verhoeven CJ, Janssen PF, van Lith JM, van Oudgaarden ED, Bloemenkamp KW, Papatsonis DN, Mol BW, van der Post JA. N Engl J Med. 2010 Jan 28;362(4):306-13. doi: 10.1056/NEJMoa0902748. Outcomes after internal versus external tocodynamometry for monitoring labor.

Harper LM, Shanks AL, Tuuli MG, Roehl KA, Cahill AG. Am J Obstet Gynecol. 2013 Jul;209(1):38.e1-6. doi: 10.1016/j.ajog.2013.04.001. Epub 2013 Apr 2. The risks and benefits of internal monitors in laboring patients.

Mol BW, Logtenberg SL, Verhoeven CJ, Bloemenkamp KW, Papatsonis DN, Bakker JJ, van der Post JA. J Matern Fetal Neonatal Med. 2015 Dec 23:1-4. [Epub ahead of print] Does measurement of intrauterine pressure have predictive value during oxytocin-augmented labor?

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