st toco fecg st-events

ST Case 18

Erroneous breech mode

Summary

A 35 year old G1 P 1. Gest. week 41+4. Pregnancy complicated by; Obesity BMI 34. Admitted to the hospital with contractions and SROM . On admission FHR pattern classified as a Green Zone tracing.

11:52 FSE applied. ST Analysis is initiated. SVE: Cx 7 cm dilated, 100% effaced, vx at 0 station. Clear fluid noted.
12:00 Patient starts to push involuntary, Baseline T/QRS is determined.
12:30 Epidural placed to avoid the strong urge to push.
13:15 SVE: Cx 8 cm dialed, 100% effaced, vx at 0 station.
13:27 FSE comes off.
13:47 FSE reapplied.
15:15 SVE: Unchanged.
16:10 Patient is pushing involuntary on and off.
16:16 SVE: Unchanged.
16:20 Decision made to perform a caesarean section due to failure to progress.
16:48 Cesarean section. Baby boy born. Birth weight 4 570 g. Apgar Score 9/10/10.

Cord gases

	pH	pCO₂	BE
Artery	7.28	6.5	-5.9
Vein	7.32	4.9	-4.7

Comment

The Baseline T/QRS was determined before patient suddenly started to push involuntarily. According to STAN guidelines it is not recommended to initiate ST Analysis during 2^nd stage with active or involuntary pushing.

Erroneous breech mode is activated between 16.10 and 16.16. It is verified in the Event Log and you will clearly see the FECG inverted especially the P and the T-wave.

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.