US ST Case 16 – Intervention

Summary

21 year old G4 P3. Gest. week 40+7. Unremarkable pregnancy.

• 07:05 Admitted to the hospital in spontaneous labor, contracting since 01:00. SVE: Cx 8 cm dilated, 100% effaced, vx at 0 station.  Membranes intact.
• 08:05 Patient denies need for pain relief. Labor continues.  AROM with clear fluid noted. FSE applied. ST Analysis initiated.
• 09:07 Baseline ST Event. SVE:  Cx 10 cm dilated, 100% effaced, vx +1. Patient coping well using breathing technique. When the ST Event occurs, the patient is changing position to left side as an intervention.
• 09:18 The FHR pattern is classified as a Green Zone tracing after changing the patient’s position.
• 09:50 Patient feels a strong urge to push. Active pushing started, crowning noted while pushing.
• 10:13 SVD. Birth weight 2995 g. Apgar Score 9/10/10.

Cord gases

Comment

According to the STAN guidelines intrauterine resuscitation is a first step to improve fetal condition. In this case there is an improvement in the FHR pattern to a Green Zone tracing and the patient was able to continue in labor and have a vaginal delivery.