CNM Certified Nurse Midwife

Category - Intrapartum

A nurse midwife is reviewing the fetal heart rate monitor tracing obtained from a G2P1 client who is in labor. The nurse midwife notes decelerations at unpredictable times in relation to contractions. The nurse midwife suspects which of the following conditions?
  1. Cephalopelvic disproportion
  2. Good fetal-well being
  3. Uteroplacental insufficiency
  4. Cord compression
Explanation
Answer: D - The nurse midwife suspects cord compression. Variable deceleration is manifested by decelerations occurring at unpredictable times in relation to contractions. This type of variability usually occurs after rupture of the membranes or in cases of oligohydramnios. Cephalopelvic disproportion is manifested by early decelerations before the head is fully descended. Early decelerations normally occur during the final stages of labor. Uteroplacental insufficiency is manifested by late decelerations.
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