Aim To determine the change in management of the pathological cardiotocograph (CTG) in labour with regards to the use of fetal blood sampling (FBS) prior to delivery by emergency Caesarean section.
Methods A retrospective study of a population delivered by emergency Caesarean section, the primary indication being an abnormal CTG was conducted in 2008. This study was repeated in 2010.
Results Fifty cases were reviewed each time. There was 50% increase in the number of FBS attempted in this re-audit. There was 85% increase in the appropriate interpretation and management of all FBS taken.
In 2008, 9/50 (18%) cases had a successful normal pH level taken but all proceeded straight to Caesarean section regardless. However in 2010, 11/13 cases (85%) had successful normal pH levels taken and all were reviewed in the appropriate time frame. 5/11 (45%) cases had repeat FBS taken. The remainder 7/11 (65%) cases were reviewed as appropriate and delivered by Caesarean section for other obstetric indications, primarily failure to progress.
A general improvement in the documentation of the procedure of FBS was noted.
Conclusions With a background of rising local and national Caesarean section rates, this re-audit demonstrates a significant increase and much improved use of FBS to establish fetal pH levels in cases where delivery by Caesarean section is contemplated because of a pathological CTG.
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