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[Brain damage in a child after outpatient induction of labour]
Stig A Hill1, Erlend T Aasheim
1Gynækologisk-obstetrisk Afdeling, Telemark Hospital, Skien, Norge.
A 32-year-old woman had labour induced (25 + 25 microgram misoprostol vaginally) at 291 days gestation for post-term pregnancy. A cardiotocography (CTG) showed normal conditions. The woman went home to await regular contractions in line with hospital policy. She awoke at 3.15 a.m. with abdominal pain and came to the labour ward at 3.45 a.m. with less pain but a desire to push. The cervix was dilated but the foetal head sat high in the pelvis. Internal CTG showed a pre-terminal pattern. A girl was born at 4.27 a.m. She had hypoxic-ischaemic encephalopathy (APGAR at 1, 5 and 10 min.: 1, 3, 3; umbilical cord arterial blood pH 6.71, base excess -19.9 mmol/l). At the age of three years she had severe cerebral palsy.
A 32-year-old woman had labour induced (25 + 25 microgram misoprostol vaginally) at 291 days gestation for post-term pregnancy. A cardiotocography (CTG) showed normal conditions. The woman went home to await regular contractions in line with hospital policy. She awoke at 3.15 a.m. with abdominal pain and came to the labour ward at 3.45 a.m. with less pain but a desire to push. The cervix was dilated but the foetal head sat high in the pelvis. Internal CTG showed a pre-terminal pattern. A girl was born at 4.27 a.m. She had hypoxic-ischaemic encephalopathy (APGAR at 1, 5 and 10 min.: 1, 3, 3; umbilical cord arterial blood pH 6.71, base excess -19.9 mmol/l). At the age of three years she had severe cerebral palsy.
