ABSTRACT
External monitoring of fetal heart rate (FHR) and uterine contractions were commenced. She had strong, painful contractions lasting 60 to 90 s, every 2 to 4 min. Baseline FHR was 130 bpm, the variability being reduced by <5 bpm. The patient delivered a 2900 g male infant covered with thick meconium. The Apgar score was 4 and 9 at 1 and 5 min, respectively. The baby was immediately laryngoscopied and the larynx was cleaned of meconium. The aim of this case presentation is to point out the importance of biochemical surveillance as an additional tool in assessment of fetal well-being. Thick meconium, reduced baseline variability, and variable decelations, particularly with a late component, are usually interpreted as an indication of fetal compromise. However, these signs may be misleading and, in some cases, additional information obtained by examination of fetal scalp blood sample together with proper clinical judgment of the dynamics of labor may prevent an unnecessary cesarean section.
