FIGURE 4-10 Fetal heart rate (FHR) decelerations and :
Pattern
Description
Nursing Intervention
Early Decelerations

  1. FHR begins to slow with the onset of the uterine contraction (UC) and returns to baseline when contraction
  2. Fetol head compression occurs.
  3. Vagal nerve stimulation.
  4. Transient slowing of FHR.
No intervention required. Continue observation.
Late Decelerations

  1. FHR begins to fall at height of the UC and returns to baseline after contraction has ceased.
  2. FHR usually remains within normal
  3. Indicates some degree of uteroplacental insufficiency.
Change maternal position.
Turn off Pitocin; increase rate of maintenance IV.
Begin oxygen by face mask
Notify physician.
Check blood pressure and pulse rate.
Possible candidate for cesarean birth.
Variable Decelerations

  1. Slowing of FHR either with a contraction or in between contractions. Unrelated pattern of FHR and uterine contraction.
  2. Pattern may be U shaped or V shaped. Transitory acceleration precedes or follows the deceleration.
  3. FHR may fall below 100 beats/min; then returns immediately to baseline.
  4. Usually indicates cord compression.
Change maternal position to alleviate cord pressure.
Turn off Pitocin; increase rate of maintenance IV.
Begin oxygen by face mask.
Notify physician.
Check blood pressure and pulse rate.
Possible candidate for cesarean birth.
Possible candidate for amnio infusion.