st toco fecg st-events

ST Case 12

Importance of CTG interpretation

Summary

A 36 year old G2 P1. Gest. weeks 41+6.  Admitted to hospital,  contracting since midday and SROM.  Meconium stained liquor. Normal pregnancy.

  • 22:10 VE: Cx fully effaced, dilated 5 cm, vx -1. FSE applied and ST analysis initiated. Thick meconium stained liquor.
  • 22:45 Epidural given and Oxytocin infusion started.
  • 00:10 VE: Cx fully effaced, 8 cm dilated, vx at 0 station.
  • 00:34 Poor signal quality
  • 00:43 FSE reapplied.
  • 00:51 Active pushing started.
  • 01:07 SVD. AS 10,10,10.Birthweight 4050 g

Cord gases

pH pCO2 BE
Artery 7.27 7.3 -4.9
Vein 7.31 6.1 -3.1

 

Comment

This case shows a good fetal reaction when FSE is applied, thereafter you see clearly the fetus Baseline Heart Rate. Between 23:12 - 23:50 it is hard to decide the Baseline Heart Rate, are there accelerations or decelerations? The physician in this case interpreted the decelerations as early decelerations and a Normal CTG, therefore no intervention when the ST Events appeared.

uploaded 2012-02-13 by Neoventa Medical