ST Case 15

Summary

A 38 year old G8 P7 Gest. week  40+3 admitted to the hospital in spontaneous labor contracting since early in the morning.  Unremarkable pregnancy.  SVE: Cx 6 cm dilated, 100% effaced, vx -1.

• 16:40 Green Zone tracing noted on admission.
• 18:18 AROM performed with thin meconium stained fluid noted. FSE applied and ST Analysis initiated. SVE: Cx 10 cm, 100% effaced, vx+2.
• 18:30 Active pushing started.
• 18:45 Spontaneous vaginal delivery. Apgar Score 9/10/10.

Cord gases

Comment

This is a case with an atypical fECG waveform and poor signal quality throughout the tracing. The T/QRS baseline is never determined; therefore, ST Analysis cannot be used to assess the fetal state. The TOCO transducer is not applied properly, labor progresses very quickly and the patient delivers after only a few pushes.

Reminder

• Check for normal ECG waveform with sufficient signal quality.
• Check for message indicating that baseline T/QRS is determined.
• Gaps in the T/QRS ratios of more than 4 minutes may result in missed ST Events.