title: [Do we have to monitor foetal heart rate during general anesthesia?].
abstract: We present a case of an emergency Caesarean section due to misinterpretation of the cardiotocography (CTG) trace during general anaesthesia for treatment of dental abscess. Following failure of the dental abscess treatment under local anaesthesia, a 29-year-old female in the 36th week of a twin pregnancy was to undergo general anaesthesia. Foetal well-being was monitored with ultrasonographic evaluations of foetal heart rate. During surgery, senior obstetrician recorded a lack of beat-to-beat variability of the cardiotocography trace. The CTG pattern was interpreted as foetal distress and an emergency Caesarean section was performed under general anaesthesia. That was probably due to general anaesthesia. Then, two infants were extracted without neonatal distress necessitating intubation. This case report underlines the risk to misread an intraoperative CTG monitoring and if the CTG monitoring is normal before anaesthesia, reduced foetal beat-to-beat variability with a normal baseline heart rate during general anaesthesia is probably normal.
authors.affiliation: Département d'anesthésie et de réanimation, CHU Nord, boulevard Pierre-Dramard, 13915, Marseille 20, France. frmart01@wanadoo.fr
authors.forename: F
authors.initials: F
authors.lastname: Martin
authors.forename: X
authors.initials: X
authors.lastname: Viviand
authors.forename: R
authors.initials: R
authors.lastname: Desbriere
authors.forename: L
authors.initials: L
authors.lastname: Boubli
authors.forename: C
authors.initials: C
authors.lastname: Martin
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D002585:Cesarean Section; D003951:Diagnostic Errors; D004562:Electrocardiography; D005260:Female; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D016343:Monitoring, Intraoperative; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D014427:Twins