st toco fecg st-events

ST Case 17

Importance of intervention

Summary

17 year old G 1 P 0. Gest. week 39+6. Unremarkable pregnancy.

08:42 Admitted to the hospital in spontaneous labor, contracting since 04:00. The patient reported SROM at 07:30 of clear fluid and has been experiencing strong painful contractions since. SVE on admission: Cx 3 cm dilated, 100% effaced, vx -2. FHR pattern classified as a Green Zone on admission. Patient denied need for pain relief.
09:48 ST Analysis initiated. IUPC inserted.
11:00 Epidural placed. SVE: Cx 6 cm dilated, 100% effaced, vx-1. Pink fluid noted on the peri pad.
11:22 Physician is requested to bedside for assessment of the FHR pattern.
11:23 Episodic ST Event.
11:31 Decision made for an emergency cesarean section, ST Analysis disconnected and patient taken to OR.
11.46 Emergency cesarean section. Baby girl 3 230 g. Apgar Score 9/10/10.

Cord gases

	pH	pCO₂	BE
Artery	7.32	4.3	-2.4
Vein	7.36	3.1	-1.8

Comment

According to the STAN guidelines intrauterine resuscitation is the first step to improve the fetal condition such as discontinue oxytocin infusion, change maternal position and increase IV fluid rate. In this case it may have been possible to avoid a caesarean section. In the end of the FHR tracing both the baseline heart rate and the variability are normal.

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.