A 28-year-old primigravida at 40 weeks gestation in active labor undergoes continuous fetal monitoring. Following contractions, the fetal heart rate demonstrates gradual decreases with nadir occurring after the peak of the contraction, recovering slowly to baseline. What do these late decelerations indicate?

Answer and explanation

Correct answer: C. Uteroplacental insufficiency and fetal myocardial hypoxia

  1. Step 1: Late decelerations feature a gradual decrease and return to baseline, with the onset, nadir, and recovery occurring after the beginning, peak, and end of the uterine contraction.
  2. Step 2: Late decelerations reflect decreased intervillous blood flow during uterine contractions leading to uteroplacental insufficiency and fetal hypoxia.
  3. Step 3: Early decelerations coincide with contraction peaks (head compression); variable decelerations are abrupt drops (cord compression).
Answer
Uteroplacental insufficiency and fetal myocardial hypoxia.
Why not the others: Early decelerations indicate head compression; variable decelerations reflect cord compression.

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