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

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.