Failure to recognise non-reassuring CTG

The Health and Disability Commissioner investigated a complaint from a 22-year-old woman about the care provided by her midwife and lead maternity carer during labour. Her baby was delivered by urgent Caesarean section and was born underweight with respiratory distress.

The woman began experiencing pain around 39 weeks into her pregnancy. She contacted her midwife who told her that what she was experiencing was normal and instructed her to take paracetamol and to rest.

On her due date, the woman contacted the midwife because she believed she was having contractions. The midwife examined her and told her she was not in labour. Two days later, the midwife examined her again and told the woman that she was in early labour.

The following day, the woman contacted the midwife, and they met at hospital for a further examination. The midwife started a CTG to monitor the fetal heart rate, which she did not interpret as significantly abnormal. After noting a small amount of yellow-green discharge, the midwife sought the advice of the charge midwife. The charge midwife confirmed that the discharge was meconium and noted that the CTG had been abnormal from the beginning. An obstetric registrar also identified the CTG to be abnormal.

Health and Disability Commissioner Anthony Hill found that the midwife breached the Code of Health and Disability Services Consumers’ Rights in several respects. She failed at the outset to recognise that the CTG was abnormal and, for the next hour, did not recognise that the CTG was abnormal. The woman had continued to smoke throughout her pregnancy and consequently was at higher than normal risk of having an underweight baby.  Accordingly, the midwife should have monitored the fetal growth more closely. The woman also had a long period of latent labour, and given that the fetal head had not descended into her pelvis, the midwife should have assessed her more thoroughly.

The midwife also failed to document her antenatal care adequately.–case-notes/commissioner’s-decisions/2013/11hdc00098–case-notes/case-notes/failure-to-recognise-non-reassuring-ctg-(11hdc00098)

Sometimes when a business is growing, it needs a little help.

Right now Kaniva News provides a free, politically independent, bilingual news service for readers around the world that is absolutely unique. We are the largest New Zealand-based Tongan news service, and our stories reach Tongans  wherever they are round the world. But as we grow, there are increased demands on Kaniva News for translation into Tongan on our social media accounts and for the costs associated with expansion. We believe it is important for Tongans to have their own voice and for Tongans to preserve their language, customs and heritage. That is something to which we are strongly committed. That’s why we are asking you to consider sponsoring our work and helping to preserve a uniquely Tongan point of view for our readers and listeners.

Latest news

Related news