Fetal Heart Rate Decelerations (Early, Late, Variable)
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- Опубликовано: 31 янв 2015
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Наука
have to disagree with the theory explained here.
the severity in ascending order is
1.early deceleration(normal)
Yes... you're absolutely right. Late decels are due to uteroplacental insufficiency. Early due to compression of the fetal head increasing vagal tone. Variable due to cord compression
My Animated tutorial on :)
ruclips.net/video/cKUFES4Zrzk/видео.html
@@dratelectasis Funny that I understood the physiology behind it from your and suranga's above comments (and I came to the internet only for that) haha.
[LATER_EDIT] Well I did just saw a video that explained it better & better :).
very well explained and thank you for that.
Helped a lot, thanks!
Thanks so much for explaining this process....great video
Excellent video. 5 stars all around. TY!
Per UWORLD: SHARP deceleration occur with contractions are still considered variable and are due to cord compression. Positioning mom in left lateral side reduces cord compression and improves blood flow to placenta. This late deceleration is not as bad. If you have a late deceleration, then there is placental insufficiency, this is a true EMERGENCY!!!
thank you. i found this point too.
Thank you! Explained clearly!
Thank youuuuu for this! Very helpful ♥️
This is so simple and organised 👌thanks
Late decelerations occur with contractions in the presence of hypoxia. They are a warning of distress and never reassuring. The start late, dip late and finish late after every contraction. The foetus is struggling to compensate with the poor oxygenation. They are never OK!
+Valerie Peers the video's trying to stress that late decelerations are not as bad as variable decelerations. In academic OB (and for board preparation purposes) the key points with late decelerations are 1) they're typically caused by uteroplacental insufficiency, 2) they're not as bad as variable decelerations, and 3) oxygenation and closer monitor of the patient is needed. All of the above are taught by this video. Thanks for your contribution.
All wrong! Late decelerations are very bad! Variables happen with short periods of cord compression.. the oxygen interruption is very brief. They happen all the time! Late decelerations are caused by uteroplacental insufficiency yes, which means the uterus is puttering out and cannot sustain or work to keep the baby oxygenated any longer. They MUST be corrected or baby will become hypoxic and develop irreversible brain injury. You are teaching this all wrong and this is preparation for med boards? Very scary! Go back to school please!Jamie Lee, RN OB nurse and Family Nurse Practitioner student!!
Thanks for explaining this and making it simple to understand
Chaz Coggins Hi
thank you so much!! you just save my nclex review!!
Verrryyyyy helpful!! Thank you
thank you for the great explanation
very good explanation thank you.
well done! since my nursing instructors could not explain it visually. Thx
easy to follow, thanks!
Amazingly explained, you explained 100% way better than my instructor. Is there anyway you can explain using a chart strip about fetal heart rate, variability, acceleration, periodic episodic, thank you in advance!
Thank you so much your video was GREAT!
+Kristin Carranco No, Kristin, YOU are great- the video is okay
excellent presentation :) 10/10
Nice and easy explained.. Tq
Thank you for the video.
Thank you so much!!
2 min in and still good. 3 min. Still with u.
I think you got late deceleration and variable backwards. I would redo with the fix cause you did an amazing job and it helped me very much. Thank you
I believe he got it correct. Late decelerations can be a sign of chronic hypoxemia and is associated with fetal growth restriction (worrisome). Whereas variable decelerations can be a sign of acute asphyxia which can cause severe or fatal brain damage due to the brain tissue being deprived of oxygen.
Thank you sir.
OMG. now I understand. thank you so much
Thanks very helpful
great video!
studying for my nclex and this helped a lot
Awesome presentation. I'm like 1 minute in
so helpful thnx
thanks i understand now
Thankyou sir
you the real MVP
Now i understand better. Thanks
you're welcome, lilian! thanks for watching
Variables are not as concerning as lates. Cord compression can be fixed (sometimes) with repositioning and in cases where there was ROM an amnioinfusion. Lates are uteroplacental insufficiency, yes, but it is a more concerning decel due to its higher likelihood that the fetus will suffer acidosis. Placental insufficiency is more often seen in PEC, GDM, HTN, IUGR, and post dates. Hope that clarifies it for some who watched this. Some of the information given in this video is very incorrect.
Thank you sir😍
Thank you so much Sir for such a simplified explanation.....☺️🙂
Thank you
thank you!!!
Thank U so much
thanks dude
thnx doc it was awesome :)
Sometimes (Often?) hypoxia during contractions will cause late (type 2) decelerations. Blood is directed to vital organs so non-vital blood vessels will vasoconstrict causing hypertension that baroreceptors detect and then with the pneumogastric nerve (cranial nerve X) the heart rate is slowed. Because this process is so long that's why there is that lag time.
Thanks
thanks
Nice
thanks.
Thanks lov
thank u sir
I have a question... are early decelerations an EXPECTED finding, or unexpected but not worrisome?
thanks so much for this video, I am studying for RN boards and this is the only simple and easy to understand tutorial that finally makes sense to me!
Sorry for the late reply, good luck on nursing boards! Early decelerations are very common, and under most circumstances not worrisome. I wouldn't say they are expected, although the baby's head gets squeezed quite a bit during the birth process producing these
@@MedSchoolMadeEasy/videos great thanks!
according to Uworld in an early deceleration, the nadir of deceleration corresponds with the peak of contraction, they "mirror," one another. Also, late deceleration is as you said uteroplacental insufficiency , the baby's O2 is being compromised, you don't just continue to monitor, you turn the mother to her left side.
thanks for the comments BlueLight. An addendum- there are several things you can do for a mother with uteroplacental insufficiency (stop pitocin, give O2, etc.), and yes, LLR positioning is one of them. But commonly with late decels the first thing to do is monitor for consistency and duration
Can you help what's a atypical deceleration
nice
The uterus is so troublesome. Got early and late. Les see how variable goes
gr* video ...................thx
late deceleration in NOT OKAY o_O
+mojo khalifa the video's trying to stress that late decelerations are not as bad as variable decelerations. In academic OB (and for board preparation purposes) the key points with late decelerations are 1) they're typically caused by uteroplacental insufficiency, 2) they're not as bad as variable decelerations, and 3) oxygenation and closer monitor of the patient is needed. All of the above are taught by this video. Thanks for your contribution.
@@MedSchoolMadeEasy Recurrent variable deceleration( variable deceleration with greater than 50% contraction) could be bad. Even with recurrent variable deceleration, the first line management is maternal positioning(which usually works). If that fails, we go for amnioinfusion. If there's absent variability plus recurrent variable deceleration, we go for CS. But late deceleration is ALWAYS BAD. So I have to disagree with you on this. For academic purpose or clinical , I think the best way to go about severity is: Late deceleration>variable deceleration>early deceleration.
incorrect info , please look it up
A fetal scalp electrode is NOT "a little wire that goes next to the baby." It is a wire that is embedded in the fetal scalp. This early mistake makes me question the rest of this talk.
❤👍
You said lates are ok and variable are the good ones. Not true. Lates are 2nd to placental insufficiency and NOT good. Uncomplicated variables are ok because they demonstrate a fetus with enough reserve while complicated variables are not good as they indicate a fetus with poor reserves.
You need to look at AWHONN and NICHD for standardized nomenclature related to FHR TRACING terminology. This isn't accurate.
+Krystle NurseWifeMommy thanks for your opinion Krystle. We'll continue to simply follow typical medical school curriculum, but if you'd like to elaborate on your comments about nomenclature/vernacular differences then please do.
+Med School Made Easy Maybe
This is what we were taught.
Variable = cord compression. reposition, give O2
Early = Head compression. Do nothing
Late = Placental insufficiency. Stop pit, repo MOB, Give 10-12 02, Flood IV, Call doc!
Late decels are NOT ok! You CANNOT just monitor more closely. Get that mom on her left side and give her O2 to prevent baby getting hypoxia.
+emdgrl the video's trying to stress that late decelerations are not as bad as variable decelerations. In academic OB (and for board preparation purposes) the key points with late decelerations are 1) they're typically caused by uteroplacental insufficiency, 2) they're not as bad as variable decelerations, and 3) oxygenation and closer monitor of the patient is needed. All of the above are taught by this video. Thanks for your contribution.
+emdgrl why left side?
+Darrell Ng , it is thought to keep pressure off of the inferior vena cava, improving blood return to the mom's heart. That makes it easier for heart to get blood to baby.
@@MedSchoolMadeEasy late decelerations are extremely bad- you do not want to see them in a CTG , it occurs in severe fetal hypoxia - get that kid out!!
Calm your balls. Jeez
It's 2016. U/s and Doppler should be outlawed
Decelerations+TP4=4YearInvestigation.
incorrect
Hi thank you! 2 weeks to due , today at the stress test baby’s heartbeat decelerated from 140 to 60s not very often,(we haven’t had a deceleration before ) however our doctor wanted to make sure and transferred us to triage. Over there with another machine heartbeat was still kept going up and down and about in an hour my wife went to the bathroom after she had some serum. When she came back the heartbeat was very stable for 30 mins. Doctor was happy about it and sent us home. Thoughts please ? I am concerned.
Thank you
uh some info in here is wrong, late decels are the worst ones, new nurses to obs better go watch another video
This is not information I would follow. You can get hypoxia with lates as well. I would rather have variables personally.
thanks cathy
Late decels not okay! better video: ruclips.net/video/iMTYiZSPjzM/видео.html
Hay thanks for the video. Some feedback. I feel like the definition of a "deceleration" is absent. Like it has an actual definition not just a decrease in the baseline. Also your video could have been 2min if you didn't repeat over and over the same thing.
you stated what the late deceleration is called by say uterine insufficiency or placental insufficiency but did not explain why it comes late. physiologically what is happening to answer why there is a delay in deceleration if their is insufficient oxygenation going on?
You have the decels backwards in importance, Lates are the worst and variables are from cord compression. Not sure where you learned your education from, but pretty much all wrong. Look up the true definition of early decal as well.
I'm an L&D nurse...this is not correct regarding lates and variables. Anyone watching please disregard this video as it is incorrect. You do a nice job presenting...so take down this video and redo with correct information. Thanks
Melanie Borthwick why not correct him then please tell us how he was wrong
Michael Sorry, there were several comments that go into specifics of what's wrong, so I didn't add :-(
All wrong! Late decelerations are very bad! Variables happen with short periods of cord compression.. the oxygen interruption is very brief. They happen all the time! Late decelerations are caused by uteroplacental insufficiency yes, which means the uterus is puttering out and cannot sustain or work to keep the baby oxygenated any longer. They MUST be corrected or baby will become hypoxic and develop irreversible brain injury. You are teaching this all wrong and this is preparation for med boards? Very scary! Go back to school please! Jamie Lee, RN OB nurse and Family Nurse Practitioner student!!
Very bad audio
Please don't watch this video- you will fail your next OB exam!!! Lates are BAD. His explanation of variable decels is WRONG. What he is "trying to stress" is wrong!
just started my first day of OB/GYN rotation and I already know this guy is getting a lot of stuff wrong. Read an article and don't waste your time with this crap
Really
do you have to talk so slow? i can't even follow it's so slow.
+redcs13ab Sorry, trying to talk slowly and clearly for learners of all levels. If you want it sped up, use the 2x speed feature. thanks
speed the video up. thats what I did
thank you !!!!!
Can you help what's a atypical deceleration
+Troy Sherlock Atypical is simply a deceleration that doesn't follow the normal early deceleration movement, as described above in the video. It can be late or variable- also described above. Thanks!
@@MedSchoolMadeEasy- Atypical deceleration is otherwise called as complicated variable deceleration (RANZCOG) - 60bpm below baseline > 60 sec, slow return, smooth overshoot, followed by higher baseline & reduced variability.
Your explanation is very poor in the video- please do not confuse students who might think the information provided is correct .