ST Case 24

Importance of reactivity

Summary

A 36 year old G1P 0. Gest.week 40+4. Admitted to hospital contracting since morning. Normal pregnancy.

  • 17:00 VE:Cx fully effaced, dilated 3 cm, vx-2.
  • 17:50 ARM, thick meconium stained liquor noted. FSE applied and ST Analysis initiated.
  • 18:10 Obstetrician called to room, decides to perform cesarean section
  • 18:27 Baby boy born.

Birth weight 2 210 g. Baby admitted to NICU, SGA. Apgar score: 7/9.

Cord gases

pH pCO2 BE
Artery 7.20 8.2 -8.5
Vein 7.25 7.1 -7.4

 

Comment

This case shows the importance of adjusting the TOCO for the assessment of decelerations. In the presence of recurrent late decelerations and decreased variability in early labor it is important to evaluate if there is a reason to continue labour. An abnormal CTG tracing with minimal variability when ST Analysis was initiated is against the recommendations.

uploaded 2013-10-03 by Neoventa Medical