st toco fecg st-events

ST Case 11

Maternal pyrexia. Stan GL followed.

Summary

26 year old G1 P0. Gest. week 41+3. Unremarkable pregnancy.

10:10 Admitted to the hospital complaining of contractions. SROM occurred 32 hours earlier, clear fluid noted. SVE: Cx 6 cm dilated, 100% effaced, vx -2.
11:11 Epidural placed.
12:30 Oxytocin infusion started. SVE: Cx 7 cm dilated, 100% effaced, vx -1.
14:30 SVE: Anterior lip, vx at 0 station. Maternal temp 37,8. IV antibiotics given.
15:14 Biphasic ST Event.
15:31 Biphasic ST Event during a Yellow Zone tracing. Intervention required. Physician assessment, decision made for cesarean section.
15:35 Biphasic ST Event.
15:36 Biphasic ST Event.
15:38 Biphasic ST Event.
15:42 Biphasic ST Event.
15:54 Emergency cesarean section. Baby girl born. Birth weight 4 410 g. Apgar Score 9/10/10.

Cord gases

	pH	pCO₂	BE
Artery	7.24	8.5	-5.9
Vein	7.32	7.2	-3.1

Comment

The first two Biphasic ST Events occurred in a Yellow Zone tracing. The STAN guidelines recommend “direct physician assessment, Intrauterine resuscitation as appropriate, If no improvement in fetal condition, expeditious delivery”. The tracing remains in the Yellow Zone, with no improvement in the fetal condition expeditious delivery was recommended.

IMPORTANT to remember: “In the presence of maternal fever, close observation is warranted”.

uploaded 2013-10-03 by Neoventa Medical

© 2018 Neoventa Medical AB | Neoventa Medical Inc. | All rights reserved | These cases are being presented to provide additional learning opportunities and demonstrate the use of STAN and ST Analysis. They are not intended to be a substitute for the product manuals or instructions for use, nor should they be taken to provide specific instructions on how to care for any patient given that the entire clinical picture must be taken into account when administering care. Patient selection and management should always be according to approved indications for use, as well as contraindications, as defined in the clinical guidelines for your point of use.