A laboring patient shows late decelerations on the fetal monitor. What does this indicate and what action is prioritized?

A laboring patient shows late decelerations on the fetal monitor. What does this indicate and what action is prioritized?

• A. Uteroplacental insufficiency; reposition, administer oxygen, discontinue oxytocin if infusing, and prepare for delivery if persistent.
• B. Cord compression; reposition the patient, consider amnioinfusion if appropriate, and notify the provider.
• C. Fetal distress; escalate to delivery planning.
• D. Early decelerations; continue monitoring.

Answer: (A)

Late decelerations signal uteroplacental insufficiency and potential fetal hypoxia during labor. The prioritized actions aim to improve placental blood flow and oxygen delivery to the fetus: reposition the mother to enhance uterine perfusion (often left lateral), administer oxygen to increase fetal oxygenation, discontinue oxytocin if infusing to reduce uterine hyperstimulation, and prepare for delivery if the pattern persists despite these measures. If the decelerations persist or worsen, delivery may be necessary to relieve the hypoxic stress.

Late decelerations signal uteroplacental insufficiency and potential fetal hypoxia during labor. The prioritized actions aim to improve placental blood flow and oxygen delivery to the fetus: reposition the mother to enhance uterine perfusion (often left lateral), administer oxygen to increase fetal oxygenation, discontinue oxytocin if infusing to reduce uterine hyperstimulation, and prepare for delivery if the pattern persists despite these measures. If the decelerations persist or worsen, delivery may be necessary to relieve the hypoxic stress.