Fetal Heart Rate Variability Flashcards

What does fetal heart rate variability indicate about the fetus?

It reflects the function of the fetal autonomic nervous system and oxygenation status — how well the fetus is tolerating intrauterine conditions.

What is absent variability in the fetal heart rate pattern?

The amplitude range is undetectable (0 bpm) — a flat line.
👉 This indicates fetal hypoxemia, metabolic acidemia, or severe CNS injury and is non-reassuring.

What is minimal variability in the fetal heart rate pattern?

The amplitude range is ≤ 5 bpm.
👉 This may occur with fetal sleep cycles, CNS depressant drugs (like magnesium sulfate or opioids), or hypoxemia.

What does moderate variability in the fetal heart rate pattern mean?

The amplitude fluctuates 6–25 bpm — this is normal and reassuring, showing an intact CNS and adequate oxygenation.

What is marked variability in fetal heart rate?

Fluctuations are >25 bpm in amplitude.
👉 This can occur with acute hypoxia, fetal movement, or stimulation (like vaginal exam or scalp stimulation).
May be transient and requires close observation.

What is a variable deceleration in fetal heart rate?

An abrupt decrease in FHR of ≥15 bpm lasting ≥15 sec but <2 min, varying in timing and shape (V, U, or W-shaped).

What causes variable decelerations in the fetal heart rate?

Umbilical cord compression — decreases blood flow and oxygen to the fetus.

What are the nursing interventions for variable decelerations?

• Reposition the mother (side to side or knee-chest).

• Stop oxytocin if infusing.

• Administer O₂ at 8–10 L/min via non-rebreather mask.

• Assess for prolapsed cord.

• Consider amnioinfusion if ordered.

• Notify provider if persistent or worsening.

hat is a late deceleration in fetal heart rate?

A gradual decrease in FHR that begins after the contraction starts, with the nadir (lowest point) occurring after the peak of the contraction.

What causes late decelerations?

Uteroplacental insufficiency, meaning the placenta is not delivering enough oxygen to the fetus (e.g., maternal hypotension, preeclampsia, post-term pregnancy).

What are the nursing interventions for late decelerations?

• Reposition the mother to left-lateral position to improve blood flow.

• Discontinue oxytocin.

• Administer O₂ at 8–10 L/min via non-rebreather mask.

• Increase IV fluids (to correct hypotension).

• Notify the healthcare provider.

• Prepare for delivery (C-section) if unresolved.

What is an early deceleration in fetal heart rate?

A gradual, uniform decrease in FHR that mirrors the contraction — begins and ends at the same time as the contraction.

What causes early decelerations in fetal heart rate?

Fetal head compression from uterine contractions, vaginal exams, or fundal pressure.

What are the nursing interventions for early decelerations?

• No intervention is needed — this is a benign and expected pattern during labor progression.

• Continue to observe and document.

What is a prolonged deceleration in fetal heart rate?

A decrease in FHR ≥15 bpm lasting 2–10 minutes.
👉 Indicates prolonged cord compression, uterine tachysystole, or maternal hypotension.
Requires immediate corrective actions similar to late decelerations.

What does the acronym VEAL CHOP help nurses remember?

It correlates FHR patterns with their causes.

Letter	FHR Pattern	Cause
V	Variable deceleration	C – Cord compression
E	Early deceleration	H – Head compression
A	Acceleration	O – OK / Oxygenated fetus
L	Late deceleration	P – Placental insufficiency

What FHR pattern indicates cord compression?

Variable decelerations (V = C).

What FHR pattern is benign and expected during labor due to head compression?

Early decelerations (E = H).

What FHR pattern indicates a healthy, well-oxygenated fetus?

Accelerations (A = O) — increase in FHR by ≥15 bpm for ≥15 seconds.

What FHR pattern suggests placental insufficiency and possible fetal hypoxia?

Late decelerations (L = P) — begin after the contraction starts and end after it ends.

A 28-year-old G1P0 at 40 weeks is on oxytocin for labor. Baseline FHR is 140 bpm. The nurse observes recurrent late decelerations. What type of deceleration is this and what should be done?

• Type: Late decelerations (due to uteroplacental insufficiency).

• Interventions:

  • Reposition to left-lateral side.

  • Stop oxytocin.

  • Give O₂ 8–10 L/min via non-rebreather.

  • Increase IV fluids.

  • Notify provider and prepare for C-section if unresolved.

What are potential causes of late decelerations?

• Maternal hypotension, preeclampsia, post-term placenta aging, or excessive uterine activity.

What are implications of persistent late decelerations on the fetus?

They indicate fetal hypoxia and acidosis, which can lead to fetal distress or demise if not corrected.

When should the healthcare provider be notified during FHR monitoring?

• When late decelerations, prolonged decelerations, or absent variability are noted.

• If nonreassuring patterns persist despite interventions.

⚡ Quick Review Summary

Pattern	Cause	Nursing Action
Variable	Cord compression	Reposition, O₂, stop oxytocin, amnioinfusion
Early	Head compression	Observe, continue monitoring
Acceleration	Fetal well-being	Normal finding
Late	Placental insufficiency	Reposition, O₂, IV fluids, stop oxytocin, notify HCP