67 Clinical outcomes of aCTG in primary midwife-led care Table 4: Case descriptions of (potential) serious adverse events after antenatal CTG in midwife-led care (continued) Total aCTGs n=5736 Case no. Outcome Case description aCTG SAEs (causality score 4-6) Cause SAE Human factors Organisational factors Patient- related factors Other factors 5 Emergency cesarean section Indication for aCTG: Reduced fetal movements. GA: 41+5. Conclusion of primary care midwife: non-reassuring aCTG. Care management: Referral to secondary care. Follow-up: Conclusion of secondary care: normal aCTG. Ultrasound: oligohydramnios. Advice: induction of labour; parents declined. During the night spontaneous onset of labour and abnormal aCTG. An emergency C-section followed. AS 8/8/10. Birthweight 2885g (<p3). No (score 0) 6 Stillbirth Indication for aCTG: Reduced fetal movements. GA: 35+1. Conclusion of primary care midwife: reassuring aCTG. Care management: Next-day ultrasound (within 24 hours). Follow-up: Next-day ultrasound and fetal death diagnosed. Birthweight 3125g. Cause of fetal death unknown No (score 0) 3
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