Question

A 29-year-old G1P0 at 42 weeks gestation presents in labor. She denies ruptured membranes. Her prenatal course was complicated by chronic hypertension. Her vital signs are: blood pressure 130/80; pulse 72; afebrile; fundal height 36 cm; and estimated fetal weight of 2400 gm. Cervix is dilatedto 4 cm, 100% effaced, -1 station, and bulging bag of water. The fetal heart rate tracing reveals five contractions in 10 minutes and repetitive late decelerations. What is the most likely cause of her late decelerations?

A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Uterine hyperstimulation
D. Occiput posterior position
E. Fetal head compression

Answer 1

The most likely cause of the late decelerations is uteroplacental insufficiency due to inadequate blood flow between the uterus and placenta.

Step-by-step explanation:

The most likely cause of the late decelerations in this case is uteroplacental insufficiency.

Uteroplacental insufficiency is a condition where there is inadequate blood flow between the uterus and placenta, resulting in reduced oxygen supply to the fetus. This can lead to fetal distress and late decelerations on the fetal heart rate tracing.

In this case, the patient has a history of chronic hypertension, which can contribute to decreased blood flow to the placenta. The presence of repetitive late decelerations indicates that the fetus is not receiving enough oxygen during contractions, further suggesting uteroplacental insufficiency as the cause.