Fetal Monitoring: Prolonged Late Decelerations

February 11, 2019

When the fetal monitor signals fetal distress, intervention is imperative.

This fetal monitor strip shows prolonged, recurrent, late decelerations. Prolonged decelerations make all labor & delivery caregivers anxious. Notice how the uterus is contracting in the bottom segment, with concurrent late fetal heart decelerations evident in the upper portion. Not only are the decelerations late and deep, with only a brief return to baseline, they keep recurring with each contraction for a prolonged period of time.

Two other features are worth mentioning:

  1. The center uterine contraction appears quite intense, which may signal either a cause or symptom of the decelerations
  2. The fetal heart variance/variability (discussed in an alternate segment) is greater than 25 beats per minute (exemplified in upper strip jagged tracing), which lends additional support for fetal distress

These findings meet the criteria for prolonged, late decelerations and if coupled with signs like meconium (baby’s first bowel movement), vaginal bleeding, poor progression of labor, prolonged labor or intense, frequent contractions, the fetus is distressed and re-assessment and intervention are imperative.

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The full-length YouTube video on the entire fourth segment:  Fetal Monitoring: Decelerations can be found at: https://www.youtube.com/watch?v=9LNkEAMof0g&t=38s