• Repositioning the patient on her side.

• Administering supplemental oxygen by a tight-fitting nonrebreather face mask at 10L/minute.

• Administering an intravenous fluid bolus.

• Administering 0.25 mg terbutaline subcutaneously, according to health care provider orders.

Variable decelerations, due to the temporarily decreased blood flow to baby.

Normally tolerated well by babies, but persistent or repetitive compression may lead to worsening hypoxemia and possible acidemia in fetus.

Montevideo units are derived by subtracting the resting tone from the peak intensity of each contraction in a 10-minute period and adding those values together. A typical adequate labor pattern may be described as at least 200 MVU resulting in progressive cervical change.

• If the fundus has the firmness of the tip of your nose, describe the contraction as mild.
• If the fundus has the firmness of your chin, describe the contraction as moderate.
• If the fundus has the firmness of your forehead, describe the contraction as strong.

visually apparent abrupt increases (defined as increases from the onset of the acceleration to peak in <30 seconds) in the FHR above the baseline.

The increase is calculated from the most recently determined portion of the baseline, and the peak must be ≥15 bpm and the acceleration must last ≥15 seconds from the onset to return to the baseline.

Before 32 weeks' gestation, an acceleration is defined as having a peak ≥10 bpm above the baseline and a duration of ≥10 seconds.

They are the most common deceleration pattern seen during labor.

The most recognizable feature of a variable deceleration is a visually apparent abrupt decrease in FHR from the onset of the deceleration to the beginning of the FHR nadir of <30 seconds. The decrease in FHR is calculated from the onset to the nadir of the deceleration and the decrease is ≥15 bpm lasting ≥15 seconds and is less than 2 minutes in duration.

The unique shape of a variable deceleration likely results from the physiologic changes usually associated with compression of the umbilical cord. Under normal circumstances immediately prior to a contraction, the umbilical vein and umbilical arteries are wide open; hence, fetal blood pressure is stable. As the contraction begins, the thinner-walled umbilical vein usually is compressed before the umbilical arteries. As the vein is compressed, the fetal body detects the decreased blood flow coming from the fetal heart. In response, the fetal baroreceptors increase the fetal heart rate to maintain fetal cardiac output.

As the contraction continues to strengthen, the umbilical arteries are compressed, increasing blood pressure. The vagus nerve now slows down the fetal heart rate. As the contraction begins to ease, the umbilical arteries are released and the fetal heart rate returns to baseline. Fetal hypertension is resolved and carbon dioxide can be cleared from the fetal body. Finally, at the end of the contraction, the umbilical vein is released. The fetus stabilizes its blood pressure and normalizes oxygenation.

• Baseline FHR rate: 110–160 bpm
• Baseline FHR variability: moderate
• Accelerations: present or absent
• Late or variable decelerations: absent
• Early decelerations: present or absent

Baseline rate:

• Bradycardia not accompanied by absent variability.
• Tachycardia

Baseline FHR variability

• Minimal baseline variability
• Absent baseline variability not accompanied by recurrent decelerations
• Marked baseline variability

Accelerations

• Absence of induced accelerations after fetal stimulation

Periodic or Episodic Decelerations\

• Recurrent variable declerations accompanied by minimal or moderate baseline variability
• Prolonged deceleration ≥2 minutes but <10 minutes
• Recurrent late decelerations with moderate FHR baseline variability
• Variable decelerations with other characteristics, such as slow return to baseline, "overshoots," or "shoulders."