[ozmidwifery] CTG stillbirth
Recently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal.To me it just proves again the unreliability of CTG's. Just interested in what others think.Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want!
Re: [ozmidwifery] CTG stillbirth
CTG's can only reveal what is happening at that moment and are subjective to interpretation.Often a CTG can look positively awful, and yet after FBS the pH is fine - and how often have many of us taken an emergency C/S to theatre because of a trace that was not reassuring - to have a screaming, healthy baby emerge (thank goodness, as you are on stand-by with resus). This is very sad Michelle, but you cannot say this has happened because CTG's are unreliable. The CTG at 3pm was probably reflecting accurately - and the poor midwife who was responsible for performing that CTG will be feeling bad enough as it is. Just my thoughts having been through a similar situation.. Sadie - Original Message - From: Michelle Windsor To: Ozmidwifery Sent: Saturday, May 27, 2006 5:15 PM Subject: [ozmidwifery] CTG stillbirth Recently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal. To me it just proves again the unreliability of CTG's. Just interested in what others think. Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want!
Re: [ozmidwifery] CTG stillbirth
Hi Michelle, CTG's have been proven to be very inaccurate, for various reason such as interpretation etc. In fact 80% of all CTG's will show some abnormality, which is staggering considering it is such a widely spread and heavily relied on tool. Why is it used?, because in most hospital's it is the best available. That is why some places are moving from CTG alone towards biophysical profiles in birth suite which is far more accurate. Often a suspicious CTG will be shown ok with BPP and the women is left alone without further interference and vice vera. Very sad.. - Original Message - From: Sadie To: ozmidwifery@acegraphics.com.au Sent: Saturday, May 27, 2006 5:38 PM Subject: Re: [ozmidwifery] CTG stillbirth CTG's can only reveal what is happening at that moment and are subjective to interpretation.Often a CTG can look positively awful, and yet after FBS the pH is fine - and how often have many of us taken an emergency C/S to theatre because of a trace that was not reassuring - to have a screaming, healthy baby emerge (thank goodness, as you are on stand-by with resus). This is very sad Michelle, but you cannot say this has happened because CTG's are unreliable. The CTG at 3pm was probably reflecting accurately - and the poor midwife who was responsible for performing that CTG will be feeling bad enough as it is. Just my thoughts having been through a similar situation.. Sadie - Original Message - From: Michelle Windsor To: Ozmidwifery Sent: Saturday, May 27, 2006 5:15 PM Subject: [ozmidwifery] CTG stillbirth Recently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal. To me it just proves again the unreliability of CTG's. Just interested in what others think. Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want!
RE: [ozmidwifery] CTG stillbirth
Hello Michelle Last week something strange has happened. Two colleague midwives had a stillbirth at home. A very normal labour, half an hour second stage, good heartbeats. When the babys head was born they saw meconium in the mouth (the water was clear when it broke minutes before). The baby was flat and gave no reaction. They tried to reanimate and called urgency. The baby died later that day. Yesterday I spoke to a colleague that works in a hospital. She told that they had on that same day (17th of May) a similar story. A woman came a few days overdue for a monitor. The monitor showed a non variable heartbeat. They controlled with another monitor, even flatter tracé, than the STAN monitor and emergency C-section. Baby had apgar 0 at birth. Clear fluid at the c-section, meconium aspirated from the lungs! After reanimation, baby lives but has very bad brain scans, so is severely damaged. The people of the tertiare hospital were called and when they came to pick up the baby, they told that they didnt understand what was happening: they had the same day already five similar cases. I think this is all very strange. Greetings from rainy Belgium Lieve Lieve Huybrechts vroedvrouw 0477740853 -Oorspronkelijk bericht- Van: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] Namens Michelle Windsor Verzonden: zaterdag 27 mei 2006 11:16 Aan: Ozmidwifery Onderwerp: [ozmidwifery] CTG stillbirth Recently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal. To me it just proves again the unreliability of CTG's. Just interested in what others think. Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want!
Re: [ozmidwifery] CTG stillbirth
Hi Sadie,I guess the thing is that alot of people believe that a normal CTG (not in labour) is reassuring for fetal well being for the next 24 hours. Obviously this wasn't the case for this baby.You said about doing emergency C/S for unressuring trace only to have the baby come out screaming don't you think this shows CTG's are unreliable?Cheers MichelleSadie [EMAIL PROTECTED] wrote: CTG's can only reveal what is happening at that moment and are subjective to interpretation.Often a CTG can look positively awful, and yet after FBS the pH is fine - and how often have many of us taken an emergency C/S to theatre because of a trace that was not reassuring - to have a screaming, healthy baby emerge (thank goodness, as you are on stand-by with resus). This is very sad Michelle, but you cannot say this has happened because CTG's are unreliable. The CTG at 3pm was probably reflecting accurately - and the poor midwife who was responsible for performing that CTG will be feeling bad enough as it is. Just my thoughts having been through a similar situation..Sadie- Original Message - From: Michelle Windsor To: Ozmidwifery Sent: Saturday, May 27, 2006 5:15 PM Subject: [ozmidwifery] CTG stillbirthRecently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal.To me it just proves again the unreliability of CTG's. Just interested in what others think.Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want! The LOST Ninja blog: Exclusive clues, clips and gossip.
Re: [ozmidwifery] CTG stillbirth
I think it shows one person's interpretation of a CTG... - Original Message - From: Michelle Windsor To: ozmidwifery@acegraphics.com.au Sent: Saturday, May 27, 2006 9:39 PM Subject: Re: [ozmidwifery] CTG stillbirth Hi Sadie, I guess the thing is that alot of people believe that a normal CTG (not in labour) is reassuring for fetal well being for the next 24 hours. Obviously this wasn't the case for this baby. You said about doing emergency C/S for unressuring trace only to have the baby come out screaming don't you think this shows CTG's are unreliable? Cheers MichelleSadie [EMAIL PROTECTED] wrote: CTG's can only reveal what is happening at that moment and are subjective to interpretation.Often a CTG can look positively awful, and yet after FBS the pH is fine - and how often have many of us taken an emergency C/S to theatre because of a trace that was not reassuring - to have a screaming, healthy baby emerge (thank goodness, as you are on stand-by with resus). This is very sad Michelle, but you cannot say this has happened because CTG's are unreliable. The CTG at 3pm was probably reflecting accurately - and the poor midwife who was responsible for performing that CTG will be feeling bad enough as it is. Just my thoughts having been through a similar situation.. Sadie - Original Message - From: Michelle Windsor To: Ozmidwifery Sent: Saturday, May 27, 2006 5:15 PM Subject: [ozmidwifery] CTG stillbirth Recently where I work a primip come in at term plus 7 days in early labour about 11pm. She had a CTG at 3pm which was reactive, good variability etc. (they do routine CTG's on post-dates women). The woman wasn't inestablished labour and the midwife suggested she return home. The woman wasn't keen for this so stayed and the FHR was auscultated every couple of hours and was normal, with the woman still not in active labour. Apparently after change of shift the next midwife couldn't find a FHR and USS confirmed the baby had died within the last couple of hours. I wasn't caring for this woman so don't know all the details but apparently she had an uneventful pregnancy although she had presented three times during pregnancy with decreased movements and the CTG's were always normal. To me it just proves again the unreliability of CTG's. Just interested in what others think. Cheers Michelle On Yahoo!7 360°: Your own space to share what you want with who you want! The LOST Ninja blog: Exclusive clues, clips and gossip.
