TY - JOUR T1 - Birth asphyxia following delayed recognition and response to abnormal labour progress and fetal distress in a 31-year-old multiparous Malawian woman JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2018-227973 VL - 12 IS - 9 SP - e227973 AU - Yvette N Löwensteyn AU - Natasha Housseine AU - Thokozani Masina AU - Joyce L Browne AU - Marcus J Rijken Y1 - 2019/09/01 UR - http://casereports.bmj.com/content/12/9/e227973.abstract N2 - Reducing neonatal mortality is one of the targets of Sustainable Development Goal 3 on good health and well-being. The highest rates of neonatal death occur in sub-Saharan Africa. Birth asphyxia is one of the major preventable causes. Early detection and timely management of abnormal labour progress and fetal compromise are critical to reduce the global burden of birth asphyxia. Labour progress, maternal and fetal well-being are assessed using the WHO partograph and intermittent fetal heart rate monitoring. However, in low-resource settings adherence to labour guidelines and timely response to arising labour complications is generally poor. Reasons for this are multifactorial and include lack of resources and skilled health care staff. This case study in a Malawian hospital illustrates how delayed recognition of abnormal labour and prolonged decision-to-delivery interval contributed to birth asphyxia, as an example of many delivery rooms in low-income country settings. ER -