ST Case 5

Late uniform declerations

Summary

34 year old G 2 P 1. Gest.week 41+5. 1999 Ceaserean section for failure to progress. Normal pregnancy.

  • 12:00 Admitted to hospital for induction of labour. 48 hours SROM. VE: Cx 1 cm long, dilated 1 cm, vx -2.  2 mg Prostinglandin given.
  • 16:40 In active labour. VE: Cx fully effaced, 3 cm dilated, vx -2. Epidural sited on maternal request.  ST analysis initiated.
  • 18:01 ST Event. VE: Cx fully effaced, dilated 6 cm, vx -1.
  • 21:15 VE:Cx fully effaced, 8 cm dilated, vx -1-
  • 22:32 Oxytocin infusion starts.
  • 22:50 VE: Status quo.
  • 00:30 Increasing Baseline Heart Rate. Maternal pyrexia. 38,1 C. IV AB and Panadol given.
  • 00:58 Overstimulation, Oxytocin infusion turned off. VE/Cx fully dilated, vx at the spines.
  • 02:30 Physician contacted because of slow progress. Physician busy in operation room.
  • 03:45 Physician contacted.
  • 03:58 ST event.
  • 04:10 Physician present, decides to deliver with vacuum extraction.
  • 04:15 Unsuccessful Vacuumextraction, desicion made to perform caesarean section.
  • 04:48 Caeserean section. Babygirl 3 345 g. AS 1, 3, 5.

Cord gases

pH BE
Artery 6.82 -18.0
Vein 6.95 -15.4

 

Comments

A case with slow progress and VBAC.  Oxytocin infusion are used even if there are strong contractions. Recurrent late decelerations that gets more pronounced towards the end. A case where STAN GL are not followed and the timeframe from ST Event to delivery is too long.

 

uploaded 2011-11-28 by Neoventa Medical