Question

As the client reaches 8 cm dilation, the nurse notes late decelerations on the fetal monitor. The FHR baseline is 165-175 bpm with variability of 0-2bpm. What is the most likely explanation of this pattern?

A. The baby is asleep.
B. The umbilical cord is compressed.
C. There is a vagal response.
D. There is uteroplacental insufficiency.

Answer 1

The most likely explanation for late decelerations with low variability of the FHR during labor at 8 cm dilation is uteroplacental insufficiency, indicating that the fetus is not receiving sufficient oxygen and nutrients from the placenta, likely requiring immediate medical intervention.

Step-by-step explanation:

The most likely explanation for late decelerations with a fetal heart rate (FHR) baseline of 165-175 bpm and reduced variability of 0-2 bpm during labor at 8 cm dilation is uteroplacental insufficiency. Late decelerations are a type of FHR deceleration that begin after the contraction has started and return to baseline after the contraction ends. This pattern suggests that the placenta is not delivering enough oxygen and nutrients to the fetus during contractions. The low variability indicates that there might be some compromise to the fetal condition. This situation may require immediate intervention, such as supplemental oxygen to the mother, changing the mother's position, stopping labor-inducing drugs, or delivery if the pattern does not improve. The variability in the FHR is a critical indicator of fetal well-being, and lack of variability can be a concerning sign.