Page 74 - 2023 Elctronic Book (3) Normal Labor_Neat

- Fetal head compression.
- Fetal hypoxia.

- Fetal acidosis.
- Fetal heart block.
- Umbilical cord compression.

Management:
- Monitor for change of fetal heart pattern.
- Change maternal position and administer o2.

- Correct maternal hypotension.
- Look for causes such as prolapsed cord.
- Put mother in knee – chest position.

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

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