Page 78 - 33Elctronic Book (3) Normal Labor

3. Early decelerations (type I dips):
decrease in fetal heart rate which begins and ends at the same time at uterine contraction,
causing a consistent V-shaped wave from that mirrors the contractions on an electronic

fetal monitoring tracing.
Causes:
Head compression during labor and this leading to increasing intracranial tension and
vaginal stimulation and slowing of the heart slowing at the onset of contraction, the lowest

point correspond with the peak of contraction.
It doesn't indicate fetal distress.

Management:
- Relieve head compression is indicated. - Monitor for change for heart rate pattern.

4. Late decelerations (type II dips):
it indicates fetal hypoxia and distress due to reduced placental blood flow caused by
uterine contractions. Deceleration begins at or near the peak of contraction is completed

when late deceleration occurs when 50% or more of uterine contractions, we suspect fetal
hypoxia.
Causes:

- Placental interruption as placenta previa and abruptio placenta.
- Internal hypotension.
- Excess uterine activity.

- Maternal DM.
- Maternal severe anemia.
- Maternal cardiac disease

Management:
- Turn patient to left side.

- Administer o2 by tight face mask.
- Correct hypotension.
- If oxytocin used, turn off.
- Infuse rapidly intravenous fluid

. - Expect expeditious delivery if not corrected in 30 min.

78

Contents