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CTG Case 17

Bradycardia in early labour

Summary

A 25 year old G1 P0 in gestation week 41+6 is admitted to the labour ward in latent phase with backache and mild irregular contractions. Normal pregnancy.

VE on admission at 15.00: Cx 1 cm long, 1.5 cm dilated, membranes intact.

CTG admission test: Baseline heart rate 155 bpm, variability>5 bpm, accelerations present, no decelerations, contractions 2/10.

  • 18.20 VE: Cx fully effaced, dilated 2 cm, vx-2. ARM, meconium stained liquor grade 1 draining. FSE applied.
  • 18.30 After ARM unprovoked decelerations. Patient is using nitrous oxide.
  • 20.08 VE: Cx fully effaced, 3 cm dilated, vx -2. Physician decides to perform a FBS.
  • 20.15 Scalp pH 6,93. Decision made to perform an emergency caesarean section.
  • 20.48 Emergency caesarean section. Baby girl. Birth weight 2720 g.

Apgar score: 4, 7, 8. 

Cord gases

pH pCO2 BE
Artery 6.92 7.2 -13.1
Vein 7.04 6.1 -8.7

 Baby admitted to NICU, discharged after 7 days.

Comment

This is a patient in early labour with tachycardia, unprovoked decelerations, bradycardia episodes, no accelerations and meconium stained liquor in an almost overdue pregnancy that is showing that the baby did not tolerate the stress of labour.

 

uploaded 2012-09-11 by Neoventa Medical