Initial management of recurrent variable decelerations should have a target of relieving potential cord compression. [8] Maternal repositioning is a reasonable first maneuver. Amnioinfusion, which reintroduces fluid into the uterine cavity, has also been shown to decrease decelerations and reduce the rate of cesarean delivery. [8]
Full Answer
What are some tips for managing variable decelerations?
Tips for Managing Variable Decelerations : Focus not only on intensity and duration, but on how factors affect baseline in second stage of labor. Publish date:June 1, 2005 By Doug Brunk PDF Download
When is medical intervention needed for variable deceleration?
If the deceleration is prolonged for a long period of time, then medical intervention is necessary. If the heart rate doesn't return back to baseline within 2 minutes, then intervention is definitely needed. So this is variable decelerations in a nutshell. Another graph showing variable decelerations is shown below.
What is a variable deceleration?
Variable decelerations can be periodic, meaning they are associated with contractions, or they can be episodic and not associated with uterine contractions.
Are variable decelerations good or bad in labor?
Variable decelerations are NOT good! Notice that every time mom has a contraction the baby’s heart rate majorly decreases. Remember a normal fetal heart rate is 110-160 bpms. The cause of the decrease fetal heart rate is due to umbilical cord compression.
How do you treat variable decelerations?
Also, you can take certain steps to treat late decelerations and improve fetal oxygen supply.Lie down in the left lateral, knee-chest, or right lateral position to relieve compression of the large vein (or vena cava) by your pregnant uterus. ... Your doctor might administer oxygen in response to late decelerations.More items...•
What should the nurse do for variable decelerations?
Variable Decelerations Repositioning of the mother can relieve this compression if it is minor. However, if these decelerations continue, it could be a sign of more serious cord compression, and the nurse should administer oxygen, stop Oxytocin (Pitocin) if applicable, and check for vaginal cord prolapse.
What is the priority nursing intervention for recurrent variable decelerations?
The priority nursing intervention for recurrent variable decelerations within minimal baseline variability is turning mom to the side because that could help fix the problem of umbilical cord compression. A nurse is caring for a client who is considering use of a hormonal intrauterine system.
What is the management of deceleration?
The principal goal of management of late decelerations is to: Replenish uteroplacental blood flow by correcting the underlying cause. Increase fetal PO2. Prevention or correction of fetal acidemia.
Do you need ac section for variable decelerations?
For example, your doctor may want to perform a cesarean section if there are severe variable decelerations early in the labor. It's considered normal if they happen before delivery and are accompanied by accelerations as well.
What do variable Decels mean?
Variable decelerations usually indicate an obstruction to the fetal blood flow through the umbilical cord or compression of the umbilical vessels within the cord.
What are recurrent variable decelerations?
Recurrent variable decelerations (>50% of contractions) Umbilical cord compression. May be associated with impending acidemia, especially if progressive increase in depth, duration, and frequency. Moderate variability and/or accelerations suggest fetus is not currently acidemic.
When are variable decelerations bad?
The definition of a significant deceleration was[10]: Variable decelerations reaching a nadir more than 60 beats per minute below the baseline and lasting longer than 60 seconds. Variable decelerations reaching a nadir of fewer than 60 beats per minute regardless of baseline and lasting longer than 60 seconds.
What are complicated variable decelerations?
COMPLICATED VARIABLE DECELERATIONS Decelerations occurring in the context of baseline bradycardia. Decelerations that drop ≤70bpm or last for ≥60 seconds.
What could be a possible cause in variable decelerations in fetal heart rate?
Variable decelerations are caused by compression of the umbilical cord. Pressure on the cord initially occludes the umbilical vein, which results in an acceleration (the shoulder of the deceleration) and indicates a healthy response.
How do you manage fetal tachycardia?
Maternal transplacental short-duration intravenous magnesium treatment should be considered as first-line therapy. Transplacental propranolol, lidocaine, mexiletine, flecainide, sotalol, and amiodarone have all been used for fetal treatment of ventricular tachycardia.
How do you manage fetal bradycardia?
Fetal bradycardia due to (poorly recorded) uterine hyperstimulation....Figure 1.reposition the mother to limit cord compression and improve her blood pressure,correct the maternal blood pressure as required; and.eliminate the uterine activity, if present, with 250μg SC terbutaline (or equivalent).
What is variable deceleration?
Variable decelerations are irregular, often jagged dips in the fetal heart rate that look more dramatic than late decelerations. Variable decelerations happen when the baby's umbilical cord is temporarily compressed. This happens during most labors.
When late decelerations are observed, should the nurse attempt to increase the oxygen delivery to fetus
When late decelerations are observed, the nurse should attempt to increase the oxygen delivery to fetus by turning the mother on her left side and/or administering oxygen. If Oxytocin (Pitocin) is being administered, it should be stopped.
What is variable deceleration?
Variable decelerations are a condition in which there is a reduced flow through the umbilical cord. The reduced flow through the umbilical cord causes variable decelerations. The umbilical cord connects the fetus to the placenta and contains three vessels, 2 arteries and 1 vein. The vein brings blood to the fetus to nourish ...
How long does it take for a variable deceleration to rise?
The shape, duration, and degree of fall below baseline rate vary. Variable decelerations fall and rise abruptly in a time period within 30 seconds with the onset and relief of cord compression.
Why are contractions and variable decelerations directly correlated?
The likely reason for this is that the contractions places pressure on the umbilical cord. This reduces flow through the umbilical cord, causing the variable decelerations. You can see how steep the decline and rise times are on the decelerations.
What is the difference between early and late deceleration?
Early and late decelerations have gradual fall and rise times. With variable decelerations, the fall and rise are very steep and abrupt. Variable decelerations also may occur at times unrelated to contractions. Early and late decelerations have some time schedule with contractions.
Is variable deceleration serious?
Being that variable decelerations are quick drops and rises back to baseline, it may not be anything too serious. When it becomes serious is when the duration lasts for a long time. Then the baby is in a state of hypoxia and medical intervention is necessary.
Accelerations vs. Decelerations
Accelerations are short-term increases in fetal heart rate by at least 15 beats per minute (bpm) that last at least 15 seconds. These accelerations occur at different times throughout labor and delivery and are a sign that the fetus has an adequate supply of oxygen.
Types of Deceleration
There are three types of deceleration that may occur during labor. Each type is categorized by the timing of the deceleration during uterine contractions. 1
What Causes Deceleration?
The cause of deceleration varies depending on the type. For example, early decelerations are caused by the compression of the baby’s head during uterine contractions. The compression causes vagal stimulation, which slows the fetal heart rate.
The Benefits and Risks of Fetal Monitoring
Electronic fetal heart rate monitoring can be used to evaluate the overall health of the fetus during labor. The primary benefit of monitoring is early detection of fetal distress, but there is also a risk of false-positive interpretations of the readings (also called tracings).
Frequently Asked Questions
Deceleration has various causes, depending on the type. For example, late decelerations (a drop in the fetal heart rate after uterine contractions) are caused by a decrease in the placental blood flow. This results in insufficient oxygen supply to the fetus (uteroplacental insufficiency). 2
Fetal Heart Tone Monitoring of Decelerations For Nursing Students and Nurses
It truly is a beautiful process from conception to birth and thereafter. One of the coolest things about the labor process is the monitoring of fetal heart tones.
Quiz & Video on Fetal Heart Tone Decelerations
After you read this article, be sure to take a Fetal Heart Tone Quiz and test your knowledge on these decelerations.
Early Decelerations
The picture above is known as an “early decelerations”. The top line is monitoring the baby’s heart rate and the bottom line is monitoring mom’s contractions. On the bottom line (mom’s contraction), you can see that the line start to go up and then down…….this means mom is having a contraction.
Variable Decelerations
This crazy looking strip is called “ variable decelerations “. I remember it because the dips in the fetal heart tones look like V’s. The v’s remind me that this is a “variable deceleration”. Variable decelerations are NOT good! Notice that every time mom has a contraction the baby’s heart rate majorly decreases.