ST Case 12 – Importance of CTG interpretation
Summary
A 36 year old G2 P1. Gest. weeks 41+6. Admitted to hospital, contracting since midday and SROM. Meconium stained liquor. Normal pregnancy.
- 22:10 VE: Cx fully effaced, dilated 5 cm, vx -1. FSE applied and ST analysis initiated. Thick meconium stained liquor.
- 22:45 Epidural given and Oxytocin infusion started.
- 00:10 VE: Cx fully effaced, 8 cm dilated, vx at 0 station.
- 00:34 Poor signal quality
- 00:43 FSE reapplied.
- 00:51 Active pushing started.
- 01:07 SVD. AS 10,10,10.Birthweight 4050 g
Cord gases
| pH | pCO2 | BE | |
| Artery | 7.27 | 7.3 | -4.9 |
| Vein | 7.31 | 6.1 | -3.1 |
Comment
This case shows a good fetal reaction when FSE is applied, thereafter you see clearly the fetus Baseline Heart Rate. Between 23:12 – 23:50 it is hard to decide the Baseline Heart Rate, are there accelerations or decelerations? The physician in this case interpreted the decelerations as early decelerations and a Normal CTG, therefore no intervention when the ST Events appeared.