st toco fecg st-events

ST Case 18

Erroneous breech mode

Summary

A 35 year old G1 P 1. Gestation weeks 41+4. Obesity, BMI 34. Admitted to Labour ward with contractions and SROM . On admission CTG is normal.

11.52 ST Analysis is initiated. FSE applied. VE: Cx fully effaced, dilated 7 cm, vx at the spines. Clear liquor is draining
12.00 Patient starts to push involuntary, the Baseline T/QRS is determined.
12.30 Epidural is sited to avoid the strong urge to push.
13.15 VE: Cx fully effaced, dilated 8 cm, vx at the spines. OR position.
13.27 FSE comes off
13.47 FSE reapplied
15.15 VE: Staus quo
16.10 Pat. is pushing involuntary on and off.
16.16 VE: Status quo.
16.20 Decision made to perform a c/section due to failure to progress.
16.48 Emergency caesarean section. Baby boy born. Birth weight 4 570 g. Apgar 9,10,10.

Cord gases

	pH	pCO₂	BE
Artery	7.28	6.5	-5.9
Vein	7.32	4.9	-4.7

Comment

The Baseline T/QRS was determined before patient suddenly started to push involuntary. According to Stan guidelines it is not recommended to initiate ST Analysis during pushing time even if it is involuntary.

Erroneous breech mode activated between 16.10 and 16.16. It is verified in the Event Log and you will clearly see the FECG inverted, especially the P and the T-wave.

uploaded 2012-09-11 by Neoventa Medical

© 2018 Neoventa Medical AB | Neoventa Medical Inc. | All rights reserved | These cases are being presented to provide additional learning opportunities and demonstrate the use of STAN and ST Analysis. They are not intended to be a substitute for the product manuals or instructions for use, nor should they be taken to provide specific instructions on how to care for any patient given that the entire clinical picture must be taken into account when administering care. Patient selection and management should always be according to approved indications for use, as well as contraindications, as defined in the clinical guidelines for your point of use.