ST Case 17

Summary

17 year old G 1 P 0. Gestation week 39+6. Normal pregnancy.

• 08.42 Admitted to Labour ward contacting since 04.00. At arrival SROM since 1 hour and strong painful contractions. VE on admission: Cx fully effaced, 3 cm dilated, vx -2, clear liquor draining.  CTG admission test is normal. No pain relief  is required in the present situation.
• 09.48 ST Analysis initiated. IUPC inserted.
• 11.00 Epidural sited. VE: Cx fully effaced, 6 cm dilated, vx-1, pinkish liquor on the pad.
• 11.22 Physician is contacted for assessment of the CTG and the fetus wellbeing.
• 11.31 Decision made for an Emergency caesarean section, ST Analysis disconnected and patient taken to OR.
• 11.46 Emergency caesarean section. Baby girl 3 230 g. Apgar 9,10,10.

Cord gases

Comment

According to Stan guidelines intrauterine resuscitation is a first step to improve fetal condition such as discontinue oxytocin infusion, change maternal position and give extra fluid. In this case maybe an unnecessary caesarean section was performed. In the end of the CTG tracing both the baseline heart rate and the variability is normal, the two most significant parameters on a CTG tracing for assessing the fetal status.