CTG Case 10

Oxytocin infusion?

Summary

34 year old G 2 P 1. Gest.week 41+5. 1999 C section. Fail to progress. Normal pregnancy.

  • 12:00 Admitted to hospital for IOL due to 48 hours SROM. VE: Cx 2 cm long,  1 cm dilated, vx-2.  2 mg Prostaglandin given.
  • 16:40 In active labour. VE: Cx fully effaced, 3 cm dilated, vx-2. 
  • 17:00 Epidural sited on maternal request.
  • 18:01 VE: Cx fully effaced, 6 cm dilated, vx-1.
  • 21:15 VE: Cx fully effaced, 8 cm dilated, vx -1.
  • 22:32 Oxytocin infusion started per protocol due to slow progress.
  • 22:50 Late recurrent decelerations noted. VE:Status quo.
  • 00:30 Increasing Baseline Heart Rate. Maternal pyrexia. 38,1. 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 Recurrent late decelerations. Physician contacted again .
  • 04:10 Physician present, decides to perform FBS. FBS pH 6,93. Decision made to deliver with vacuum extraction.
  • 04:15 Unsuccessful Vacuumextraction, desicion made to perform a 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 previous section. Using Oxytocin infusion even if  there are strong contractions. Recurrent late decelerations on and off that gets more pronounced towards the end. In this case no notice taken to clinical history and CTG pattern that has been abnormal since 23.20.

uploaded 2011-11-28 by Neoventa Medical