Abstract 7 The most common events of malpractice in relation to delivery causing severe asphyxia
n (%)
Neglecting to supervise fetal well-being173 (98)
No CTG recording after admission test12
Uninterpretable CTG recordings (poor quality)41
No fetal blood sampling (FBS) despite a clear indication100
No follow-up of previous FBS despite non-assuring CTG20
Neglecting signs of fetal asphyxia126 (71)
More than 45 minutes from onset of pathological CTG to birth126
Increasing intravenous oxytocin infusion despite pathological CTG*126
Hyperstimulation of uterine contractions†61
Malpractice around delivery92 (52)
Time from decision on delivery to birth exceeded 30 minutes44
Spontaneous vaginal delivery despite longstanding (>45 minutes) pathological or uninterpretable CTG recordings48
Traumatic instrumental delivery44
Inadequate trial of labour25
Too much time using the vacuum extractor to deliver (>20 minutes)‡19
  • *Defined according to FIGOS classification and the Krebs intrapartum fetal heart rate scoring system (6).

  • †Six or more uterine contractions/10 minutes for >20 minutes

  • ‡Four had more than two cup detachments with vacuum extractor