CTG Case 19

Unnecessary intervention

Summary

A 22 year old G2 P1 in gestation weeks 41+5 with a normal pregnancy. In 2000 SVD 3230 g and in 2001 SVD 3390 g. Admitted to labour ward  with strong contractions. Admission CTG test is normal.

  • 20.32 External CTG initiated, loss of contact. SROM, clear liquor draining. Epidural sited.
  • 20.43 VE: Cx fully effaced, 6 cm dilated, vx -1. FSE applied.
  • 22.42 VE: Cx fully effaced, 9 cm dilated, vx at the spines.
  • 23.00 Physician is interpreting CTG due to low baseline heart rate. Decision made to perform forceps.
  • 23.05 VE: Cx fully dilated, vx +1. FSE removed and external trace is started.
  • 23.34 Forceps delivery. Baby girl 3 450 g.

Apgar score: 9,10,10.

 

Cord gases

pH pCO2 BE
Artery 7.28 7.9 -3.1
Vein 7.34 6.4 -2.8

 

Comment  

Baseline heart rate is normal and when applying the FSE there is a good reaction from the fetus with normal variability. At 22.42 a good reaction when a vaginal examination is done. In this case there are positive signs such as variability, early decelerations, short labour and a low risk pregnancy. Unnecessary intervention.

uploaded 2012-11-21 by Neoventa Medical