ST Case 1

Sepsis

Summary

39 year old G 1 P 0 Gest.week 41+5.

  • 12:00 Admitted to hospital contracting since 23:00 pm and SROM since 22:00 pm. At arrival VE: Cx fully effaced, 3 cm dilated, vx-2. Clear liquor draining.
  • 13:00 EDA
  • 16:37 VE fully effaced, 4 cm dilated, vx -1.  FSE applied and ST analysis started. Baseline heartrate increasing. Maternal temperature 38,2 C. IV AB and Panadol given.
  • 17:00 Oxytocin infusion started.
  • 18:40 Recurrent late decelerations noted on the CTG trace.
  • 18:54 First ST Event.
  • 19:20 Obsterician decides to perform caesarean section.
  • 19:48 Babygirl born. Birthweight 3 510 g. AS 4,7,7.

Cord gases

pH BE
Artery 6.95 -18
Vein 6.98 -11

Babygirl admitted to NICU for observation and antibiotics treatment. Presumed sepsis. Group B strep found. 

Comment

Recurrent late decelerations and increasing Baseline heartrate with minimal variability belong to an Abnormal trace. In the presence of maternal pyrexia, close observation is warranted.

The first ST event was at 18:54 and the delivery was at 19:48. Unfortunately too long decision making, almost 1 hour.

uploaded 2011-11-14 by Neoventa Medical