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Variable decelerations: generally a result of umbilical cord compression, and contractions may further compress a cord when it is wrapped around the neck or under the shoulder of the fetus. They are defined as abrupt decreases in fetal heart rate, with less than 30 seconds from the beginning of the decrease to the nadir of heart rate.
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.
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.
On cardiotocography (CTG), umbilical cord compression can present with variable decelerations in fetal heart rate. [1] Treatment
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 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]
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 ...
The term is also sometimes used to designate late decelerations of fetal heart rate as measured by cardiotocography or an NST, even if there is no other evidence of reduced blood flow to the placenta, normal uterine blood flow rate being 600mL/min.