A nurse is monitoring an electronic fetal monitor (EFM) strip for a client in active labor. The baseline fetal heart rate is 150 bpm with good variability. With each contraction, the FHR drops to 110 bpm and returns to baseline within 30 seconds of the contraction ending. How should the nurse interpret this pattern?
- A.Late decelerations, indicating uteroplacental insufficiency
- B.Variable decelerations, indicating umbilical cord compression
- C.Early decelerations, a benign response to fetal head compression
- D.Prolonged decelerations, requiring emergency delivery
Show answer & rationale
Correct answer
C. Early decelerations, a benign response to fetal head compression
Rationale
C is correct: Early decelerations mirror contractions; they begin with the contraction and return to baseline as the contraction ends (uniform shape, onset-to-nadir >30 seconds). They result from vagal stimulation caused by pressure on the fetal head during contractions. Early decelerations are a normal, benign finding requiring no intervention. A is incorrect: Late decelerations begin after the peak of the contraction and return to baseline after the contraction ends. They indicate uteroplacental insufficiency and are non-reassuring. B is incorrect: Variable decelerations have an abrupt onset and variable shape; they are caused by umbilical cord compression and may require position changes. D is incorrect: A prolonged deceleration lasts 2-10 minutes. This pattern returns to baseline quickly with each contraction, which is not prolonged.
Key concepts