CTG Case 18

Summary

A 26 year old G1 P0 in gestation weeks 41+3 with normal pregnancy.

• 10.10 Admitted to labour ward contracting and SROM since 32 hours and clear liquor draining. VE: Cx fully effaced, dilated 6 cm, vx -2.
• 11.11 Epidural sited on maternal request.
• 12.30 Oxytocin infusion started. VE: Cx fully effaced, dilated 7 cm, vx -1.
• 14.30 VE: Anterior lip, vx at 0 station. Maternal temperature 38. 2. One dose of antibiotics given i.v.
• 15.15 FBS taken due to abnormal CTG.
• 15.22 Lactate 6.2
• 15.31 Decision to perform caesarean section after physician assessment.
• 15.54 Emergency caesarean section. Baby girl with birth weight 4410 g.

Apgar score: 9, 10, 10.

Cord gases

Comment  

A high maternal temperature leads to an increased metabolism in the fetus with increased need for oxygen as a result. The fetus produces heat independently of the mother and the fetus’ body temperature is always approximately half a degree higher than the mother's. The fetus reacts to the increasing temperature with tachycardia, which usually ceases when antipyretic agents and fluid are administered to the mother. Regardless of what causes the rise in temperature, maternal fever results in fetal tachycardia.