Which fetal monitoring pattern indicates distress?

• A. Early decelerations with normal variability
• B. Accelerations with regular baseline
• C. Non-reassuring patterns such as persistent late decelerations or recurrent variable decelerations
• D. No decelerations with sustained high heart rate

Answer: (C)

Understanding fetal heart rate patterns helps you assess how the fetus is tolerating labor. Distress shows up in non-reassuring patterns, particularly when there are late decelerations or recurrent variable decelerations. Late decelerations are gradual drops in heart rate that start after a contraction begins and don’t recover until after the contraction ends; when they persist, they signal uteroplacental insufficiency and possible fetal hypoxia, prompting urgent assessment and intervention. Recurrent variable decelerations are abrupt drops in heart rate that vary in timing and depth and often point to intermittent cord compression; if these occur repeatedly, they raise concern for compromised oxygen delivery and require prompt actions to improve fetal status.

In contrast, early decelerations are typically benign and caused by head compression during labor; accelerations with a normal baseline indicate fetal well-being and adequate oxygenation; no decelerations with a sustained high heart rate may suggest tachycardia, which needs separate evaluation but is not the pattern associated with distress in itself.