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Fetal heart rate changes in labor
Renee is a 22 year old G2 P0 at 42 weeks of gestation in active spontaneous labor. Her pregnancy has been complicated by mild hypertension, but no medications were needed. She is 4 cm/100/0 station, vertez
position. Her membranes have just ruptured, and there is thick meconium staining. She is comfortable and using epidural anesthesia.
1. What risk factors are present that may impact the way this fetus tolerates labor?
2. The fetal heart rate shows a rate of 140, moderate variability, no accelererations, and decelerations to 120 beginning after the peak of most contractions and recovering to baseline 30 seconds after the contraction ends. Contractions are every 4 minutes. How should the nurse describe this pattern?
3. What should the nurse do at this point?
4. Renee is now 8/100/0. She has the above actions that you put in place. The fetal heart rate is 145. There is moderate variability. Accelerations are not present. There are decelerations in the fetal heart rate beginning at the onset of a contraction, descending to 120 with recovery by the end of a contraction. The contractions are every 3 minutes now. How would the nurse describe the fetal heart reate pattern now?
5. Renee is now completely dilated and +1 station. She has been instructed to push with every contraction. The fetal heart rate is now 164. There is absen variability and decelerations to 120 are occurring with maternal pushing, which do not resolve until 30 seconds after the contraction. The contractions are every 1 1/2 minute. How should the nurse describe this pattern?
6. What should the nurse do in this situation?

Answer 1

answer

1. here the prgnancy is post term (42 wks)and is having high blood pressure . post term delivery are having complications to both mother and fetus like prolonged labour , use of assisted devices like vaccum or forceps , cesarian delivery , postpartum hemorhages , wound infection ...

foetal complications includes meconium aspiration syndrome, still birth , malnutrition , shoulder dystocia , heart rate abnormality , umbilical cord compression , respiratory distress,

2. it is varaiable deceleration , occurs due to cord compression during uterine contraction , fetal heart rate return backs to baseline within 30 seconds , not more than 2 minutes,

3. reposition of the mother , measure vitals including sp02 level and correct using oxygen adminstrations , reduce flow of oxytocin , monitor fetal heart rate closely.

4. it is called early decelaration . caused by compression of fetal head in the birth canal during uterine contraction , this condition is normal , no emergency intervention needed at this time , but monitor maternal and fetal conditions closely

5.this situation known as prolonged late deceleration ,in this condition fetal heart rate start decreasing after the peak of contraction and returns to baseline after 30 seconds of end of contraction .

the main cause for this pattern is uteroplacental insufficiency ,maternal hypotension , maternal hypoxemia.  there will be decreased blood flow to placenta when uterus contracts .this is not good to the foetus as it cause foetal acidemia and can affect all organ functions

6.as a nursing intervention , can give oxygen to mother to increase oxygen delivery to foetus .check vitals and fluid adminster if needed . if oxytocin flow is higher , then try to reduce the rate of flow to reduce excess uterine contractions .