Page 226 - ترم ثاني كتاب تمريض صحة الام الكتروني

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5. Variable deceleration:
variable decelerations are irregular, often jagged dips in the fetal heart rate that

look more dramatic than late decelerations.
Causes:
- Intermittent compression of umbilical cord by fetal head.

- Oligo hydrominos.
- Cord between fetus and mother's uterus or pelvic without obvious prolapse.
Management:

- Change maternal position to decrease cord compressive (turn sides to side or
knee chest position).
- Give O2 at 8 – 10 L/min by tight face mask.
- Improve circulating volume.

- Amnion per fusions.
- Monitor for change fetal heart pattern dis continue oxytocin if it being

administered.
- Perform vaginal examination to assess for prolapsed cord

6. Prolonged deceleration:

there are isolated deceleration which last longer than 60 – 90 seconds.
Causes:
- Tetanic uterine contractions.

- Placental abruption.
- Umbilical cord prolapse.
- Maternal hypoxia.

Management: - Notify physician or mid wife of first occurrence.
- Check for cord prolapse.
- Examine the cervix.

- Check progress of dilation and descent.
- Correct maternal hypotension increase intravenous fluids.
- Continuous observation until delivery be prepared for emergency delivery.

7-Sinusoidal pattern:
it indicates fetal anemia as in case of ruptured vasa praevia, feto maternal

haemorrhage, twin-to-twin transfusion syndrome, and Rh-immunization.
Causes:

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