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A 'gradual' deceleration has a time from onset to nadir of 30 seconds or more. Early decelerations begin and end at approximately the same time as contractions, and the low point of the fetal heart rate occurs at the peak of the contraction. [7] Late decelerations: a result of placental insufficiency, which can result in fetal distress ...
A normal nonstress test will show a baseline fetal heart rate between 110 and 160 beats per minute with moderate variability (5- to 25-interbeat variability) and 2 qualifying accelerations in 20 minutes with no decelerations. "Reactive" is defined as the presence of two or more fetal heart rate accelerations within a 20-minute period. Each ...
During uterine contractions, fetal oxygenation is worsened. Late decelerations in fetal heart rate occurring during uterine contractions are associated with increased fetal death rate, growth retardation and neonatal depression. [1] [2] This test assesses fetal heart rate in response to uterine contractions via electronic fetal monitoring.
In response to this, the proportion of umbilical venous blood diverted to fetal heart increases. [25] This eventually leads to elevation of pulmonary vascular resistance and increased right ventricular afterload. [26] [27] [28] This fetal cerebral redistribution of blood flow is an early
The condition is detected most often with electronic fetal heart rate (FHR) monitoring through cardiotocography (CTG), which allows clinicians to measure changes in the fetal cardiac response to declining oxygen. [1] [5] [4] Specifically, heart rate decelerations detected on CTG can represent danger to the fetus and to delivery. [4]
Amnioinfusion is a method in which isotonic fluid is instilled into the uterine cavity.. It was introduced in the 1960s as a means of terminating pregnancy and inducing labor in intrauterine death, but is currently used as a treatment in order to correct fetal heart rate changes caused by umbilical cord compression, indicated by variable decelerations seen on fetal heart rate monitoring.
Umbilical cord prolapse should always be considered a possibility when there is a sudden decrease in fetal heart rate or variable decelerations, particularly after the rupture of membranes. With overt prolapses, the diagnosis can be confirmed if the cord can be felt on vaginal examination.
The presence of these biophysical variables implies absence of significant central nervous system hypoxemia/acidemia at the time of testing. By comparison, a compromised fetus typically exhibits loss of accelerations of the fetal heart rate (FHR), decreased body movement and breathing, hypotonia, and, less acutely, decreased amniotic fluid volume.