SBA: A primiparous woman at 39 weeks of gestation is in labour at 8 cm dilation. The cardiotocography (CTG) has been classified as pathological due to a base rate of 105 bpm and persistent, long standing typical decelerations. Fetal blood sampling (FBS) has been performed, showing a pH of 7.29. What is the most appropriate management option? A. Needs caesarean section immediately with general anaesthetic due to fetal hypoxia B. Needs delivery within 30 minutes due to fetal hypoxia C. Repeat FBS in no more than 1 hour if CTG remains the same D. Repeat FBS in no more than 20 minutes independent of CTG findings E. Repeat FBS in no more than 30 minutes is CTG remains the same The answer is Repeat FBS in no more than 1 hour if CTG remains the same. Remember to follow the NICE guidelines (NICE Clinical Guidelines 55, 2007) where pH >7.25 = normal. After a normal FBS result, sampling should be repeated no more than 1 hour later if the FHR trace remains pathological, or sooner if there are further abnormalities.
Posted on: Wed, 25 Jun 2014 07:07:17 +0000
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