ST Case 22

Summary

A 34 year old G3 P0 in gestation weeks 41+3 with a normal pregnancy is admitted to the labour ward with mild contractions and request concerning early pain relief. VE on admission: Cx 1 cm long, 2 cm dilated, membranes intact, vx -1.

• 19.19 Nitrous oxide is used.
• 20.00 VE: Cx  fully effaced, 2 cm dilated, vx -2.
• 20.18 Epidural sited.
• 23.04 Epidural top up.
• 00.08 VE: Cx fully effaced, dilated 4 cm, vx -1. ARM, meconium stained liquor. FSE is applied and ST Analysis is initiated.
• 03.43 VE: Cx  fully effaced, dilated 8 cm, vx -1, meconium stained liquor grade 1. Epidural top up.
• 07:13 VE: Anterior lip, vx at the spines, meconium stained liquor grade 1.
• 09.37 CTG interpreted by physician, decision made for continued observation.VE: Fully dilated, vx +1.
• 11.30 Active pushing
• 12.10 VE by physician: Cx fully dilated, vx +1. Physician decides to perform a vacuum extraction.
• 12.28 Baby girl born. Birth weight 4320 g.

Apgar score: 9, 10, 10.

Cord gases

Comment

In this case the addition of ST Analysis gave support to the decision to continue labour and avoid an earlier termination.