Intraiiteriene dood tydens monitor van die fetale harttempo

Odendaal, H. J. (1980-05)

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Although the fetal heart rate was being monitored in 16 378 patients during labour, intra-uterine death occurred in 13 cases (0,08%). These fetuses had birth weights of more than 1 000 g. In one patient monitoring was discontinued long before delivery, and fetal death occurred when a partially dilated cervis prevented quick delivery of the fetus which presented by the breech. In all the remaining patients an abnormal fetal heart rate pattern preceded intra-uterine death. Fetal death was probably unavoidable in 4 patients, even with monitoring. Abnormal fetal heart rate patterns were recorded in 2 of these, but the fetuses were estimated as being too small to be delivered by caesarean section. However, they weighed 1 160 g and 1 120 g. The 3rd patient had severe fetal bradycardia on admission and intra-uterine death occurred soon afterwards. The 4th patient refused caesarean section for a prolapse of the umbilical cord, and a vacuum extraction was attempted when the cervix was not yet fully dilated. Severe variable decelerations occurred in 5 of the 8 patients in whom intra-uterine death could have been avoided. Severe bradycardia was present in 3 patients immediately before fetal death, but it may have been present in more patients because the fetal heart rate was not recorded in all cases until death had occurred.

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