Sunday, 14 September 2014

Cardio tocography Decelerations during fetal monitoring

1. Early decelerations: due to fetal head compression during uterine contractions leading to fetal vagal stimulation leading to fetal bradycardia ( with fetal hr staying above 100bpm).

Lowest fetal heart rate- at peak of uterine contractions


2.

Late decelerations: due to dip in fetal heart rate due to fetal hypoxia during uterine contractions sign of uteroplacental  insufficiency .

Lowest fetal HR- after peak of uterine contractions


3. Variable deceleration:  poorly related to uterine contractions sign of umbilical cord compression- most serious

Lowest fetal hr- unrelated to uterine contractions

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 Normal baseline variability- changes in heart rate <5bpm are normal
Loss of normal variability- drugs, fetal hypoxia

How to manage worrying decelerations- late, variable
1. Left lateral position of mother
2. Give mother supplemental oxygen
3. Tocolytic medications- terbutaline, magnesium, nitroglycerin

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