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CTG Case 20

Late repetitive decelerations

Summary

A 39 year old G1 P0 in gestation weeks 41+5 is admitted to the labour ward contracting since 23.00 and SROM since 22.00

12:00 VE: Cx fully effaced, 3 cm dilated, vx-2. Clear liquor draining.
13:00 Epidural sited.
16:37 VE fully effaced, 4 cm dilated, vx -1. FSE applied. Baseline heart rate is increasing. Maternal temperature 38.2 C. IV antibiotics and paracetamol given.
17:00 Oxytocin infusion started.
18:40 Recurrent late decelerations noted.
19:20 Physician decides to perform caesarean section.
19:48 Baby girl born. Birth weight 3 510 g.

Apgar score: 4,7,7.

Baby girl admitted to NICU for observation and antibiotics treatment for presumed sepsis. Group B strep found. The baby is discharged in good condition after 9 days.

Cord gases

	pH	pCO₂	BE
Artery	6.95	7.2	-16.2
Vein	6.99	6.7	-11.0

Comment

Recurrent late decelerations and increasing baseline heart rate with minimal variability is an abnormal trace. In the presence of maternal pyrexia, close observation is warranted. At 19.30 the fetus has difficulties to keep its baseline heart rate and the variability is decreasing.

uploaded 2012-11-21 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.