A Study Guide in Fetal Surveillance

17 - Fetal Surveillance (11)

Acceleration: Reassuring
- Description/Appearance: o Rate increase of at least 15 beats/minute that lasts for a minimum of 15 seconds o Rate increases often in response to fetal movement o May accompany contractions
- Cause: o Interaction between sympathetic and parasympathetic nervous systems - Nursing Interventions: o None

Early Decelerations: Reassuring
- Description/Appearance: o Rate decrease during contraction o Often seen in late labor when head is on perineum o Usually FHR begins to decrease at start of contraction with lowest point of FHR corresponding with the peak of the contraction o FHR returns to baseline by end of contraction o FHR is uniform in shape and mirrors the contraction with gradual descent and return to baseline - Cause: o Head compression
 This causes the vagus nerve to slow the HR
- Nursing Interventions: o None

Late Decelerations:
- Description/Appearance: o Rate decrease during contraction o Non-reassuring if persistent o May occur WNL of the FHR (110-160) o Worse if accompanied by decreased variability or tachycardia o Usually FHR does not decrease until peak of contraction o Lowest point of FHR is after the peak of the contraction o Return to baseline does not occur until after contraction is over o FHR is uniform in shape with gradual descent and return to baseline; May be very subtle - Cause: o Insufficient function of the uteroplacental unit (impaired gas exchange) - Nursing Interventions: o Turn off oxytocin, if applicable o Give mom O2 per mask at 10L o Increase IV fluids o Reposition mom to (Left) side o Call Dr o Anticipate possible order for tocolytic

Variable Decelerations:
- Description/Appearance: o FHR decreases; may or may not be associated with contractions o Non-reassuring if:
 Occurs frequently
 Takes a long time to return to baseline
 Drop is very deep o Classified as mild, moderate, or severe o FHR decrease begins and ends