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The Intrauterine Pressure Catheter (IUPC) measures the strength and length of uterine contractions more accurately than external monitors when needed for patient and fetal safety. The IUPC may only be inserted by a physician for patients with ruptured membranes. Correct placement is confirmed by seeing amniotic fluid flow through the catheter. The IUPC is secured and connected to the fetal monitor to record contraction data like frequency, duration, and intensity. The IUPC should be removed gently once monitoring is complete.

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Intrauterine Pressure Catheter (IUPC) NLC P/P# 6600.0910
Purpose: The Intra Uterine Pressure Catheter (IUPC) is used to accurately measure strength and length of uterine contractions when external toco transducer is inadequate to ensure the safety of the patient and the unborn fetus. Policy: Only patients with ruptured membranes have an IUPC inserted. The IUPC may only be inserted by a physician.
Contraindications for Use: • Bleeding of undetermined origin • Diagnosed or suspected placenta previa • Non-ruptured amniotic membranes
1. Turn Fetal monitor, plug interface cable into the fetal monitor’s “uterine activity” outlet. 2. Using aseptic technique, remove catheter from package, and prepare for insertion. 3. Ensure amniotic membranes are ruptured, and cervix is adequately dilated. 4. Place the patient in dorsal lithotomy position. 5. Assist physician in performing vaginal exam, physician will determine optimal position for catheter placement. 6. Prepare amnio hook for rupture of membranes if no SROM. 7. Ensure amnioport is vented by confirming filtered vented cap is in place on amnioport (see Appendix A for Diagram, Figure A).
8. Using sterile technique, the Koala IPC 5000 is given to the physician for insertion. 9. The physician inserts the IUPC and confirms placement by watching for amniotic fluid flowing back through catheter length (see Appendix A). 10. To secure the IUPC, remove paper from adhesive pad and secure catheter or cable connector to the center of the pad, pinching adhesive pad around it. Secure to the patient’s thigh as closest to the introitus as possible to prevent a bend from working the catheter out of the uterus (see Figure E, Appendix A). 11. Zero the monitor by adjusting the control for “uterine activity” (this is done when the patient is not having a contraction). For true zero, ensure the catheter is disconnected from the cable and zero the monitor. Do not zero monitor while holding cable button (if present). 12. Remove yellow protective cap from catheter. Connect cable to catheter. 13. Verify proper placement by encouraging the patient to cough, and confirming a sharp spike on the uterine activity tracing.
14. Document time of insertion of IUPC, and the following data in patient’s medical record: • Time of insertion • patient tolerance of procedure • resting tone • Contraction pattern: frequency, duration, and intensity after insertion. 15. FHR Troubleshooting: If the Koala does not respond, assist the physician in the following: • Disconnect catheter from cable, flush 10cc–20ccs through amnio port, then reconnect. • Disconnect catheter from cable, rotate, retract, or advance catheter, wait 15 seconds, then reconnect.
16. Continue to monitor the patient for uterine hyperstimulation and/or inadequate resting tone. Uterine activity is quantitated by measuring Montevideo Units (MU). 17. Calculate MU’s by adding together the amplitudes of each contraction in a 10 minute period and document every 15 – 30 minutes MU. (Amplitude is calculated by subtracting the resting tone from the peak intensity of each contraction.) 18. Notify the physician if the totals are less than 200 MU or greater than 300 MU if on pitocin (usual totals are less than 250 MU in un-stimulated labor).
IUPC Removal A. Grasp catheter and pull gently until fully withdrawn. B. Disconnect catheter from cable. C. Discard catheter and clean cable with Caviwipes. D. Store reusable cable in the monitor draw.

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Iupc

  • 1. Intrauterine Pressure Catheter (IUPC) NLC P/P# 6600.0910
  • 2. Purpose: The Intra Uterine Pressure Catheter (IUPC) is used to accurately measure strength and length of uterine contractions when external toco transducer is inadequate to ensure the safety of the patient and the unborn fetus. Policy: Only patients with ruptured membranes have an IUPC inserted. The IUPC may only be inserted by a physician.
  • 3. Contraindications for Use: • Bleeding of undetermined origin • Diagnosed or suspected placenta previa • Non-ruptured amniotic membranes
  • 4. 1. Turn Fetal monitor, plug interface cable into the fetal monitor’s “uterine activity” outlet. 2. Using aseptic technique, remove catheter from package, and prepare for insertion. 3. Ensure amniotic membranes are ruptured, and cervix is adequately dilated. 4. Place the patient in dorsal lithotomy position. 5. Assist physician in performing vaginal exam, physician will determine optimal position for catheter placement. 6. Prepare amnio hook for rupture of membranes if no SROM. 7. Ensure amnioport is vented by confirming filtered vented cap is in place on amnioport (see Appendix A for Diagram, Figure A).
  • 5. 8. Using sterile technique, the Koala IPC 5000 is given to the physician for insertion. 9. The physician inserts the IUPC and confirms placement by watching for amniotic fluid flowing back through catheter length (see Appendix A). 10. To secure the IUPC, remove paper from adhesive pad and secure catheter or cable connector to the center of the pad, pinching adhesive pad around it. Secure to the patient’s thigh as closest to the introitus as possible to prevent a bend from working the catheter out of the uterus (see Figure E, Appendix A). 11. Zero the monitor by adjusting the control for “uterine activity” (this is done when the patient is not having a contraction). For true zero, ensure the catheter is disconnected from the cable and zero the monitor. Do not zero monitor while holding cable button (if present). 12. Remove yellow protective cap from catheter. Connect cable to catheter. 13. Verify proper placement by encouraging the patient to cough, and confirming a sharp spike on the uterine activity tracing.
  • 6. 14. Document time of insertion of IUPC, and the following data in patient’s medical record: • Time of insertion • patient tolerance of procedure • resting tone • Contraction pattern: frequency, duration, and intensity after insertion. 15. FHR Troubleshooting: If the Koala does not respond, assist the physician in the following: • Disconnect catheter from cable, flush 10cc–20ccs through amnio port, then reconnect. • Disconnect catheter from cable, rotate, retract, or advance catheter, wait 15 seconds, then reconnect.
  • 7. 16. Continue to monitor the patient for uterine hyperstimulation and/or inadequate resting tone. Uterine activity is quantitated by measuring Montevideo Units (MU). 17. Calculate MU’s by adding together the amplitudes of each contraction in a 10 minute period and document every 15 – 30 minutes MU. (Amplitude is calculated by subtracting the resting tone from the peak intensity of each contraction.) 18. Notify the physician if the totals are less than 200 MU or greater than 300 MU if on pitocin (usual totals are less than 250 MU in un-stimulated labor).
  • 8. IUPC Removal A. Grasp catheter and pull gently until fully withdrawn. B. Disconnect catheter from cable. C. Discard catheter and clean cable with Caviwipes. D. Store reusable cable in the monitor draw.