acute hypoxia

Question 1

CTG example of acute hypoxia

Answer 1

Question 2

Clinical picture

Answer 2

This primigravid woman was being augmented with oxytocin and is in the early second stage of her labour

Question 3

CTG Description

Answer 3

with a baseline rate of approx 175-180 bpm and (reflex) lat decelerations, which are prolonged
4:10 contractions
lasting > 2mins

Question 4

Interpretation

Answer 4

this tachycardia represents an increase in sympathetic stimulation in an attempt to increase its cardiac output and improve its oxygenation

the late decelerations reflect the evolving acute hypoxia from the uterine hyperstimulation (by hypotonus)

Question 5

Management

Answer 5

Active management is required

• cease oxytocin infusion
• notify senior staff
  (would be an appropriate start)
• The fetus is acutely hypoxic,
• depending on progress consideration should be given to tocolysis or immediate delivery