A fetal heart rate pattern shows variable decelerations occurring with most contractions, with return to baseline, no loss of variability, and no late component. Duration of deceleration is less than 30 seconds. This Category I/II/III classification and the MOST appropriate management is:

• A Category III — immediate cesarean section
• B Category I — routine monitoring, no intervention needed
• C Category II — immediate scalp pH testing and delivery if pH < 7.25
• D Category II — intrauterine resuscitation, repositioning, and close monitoring ✓

Explanation

Recurrent variable decelerations with otherwise preserved variability and no late component represent a Category II (indeterminate) FHR pattern. Intrauterine resuscitation measures — maternal repositioning (left lateral), IV fluid bolus, oxygen, and release of cord compression — are indicated. Category III would require immediate delivery and includes sinusoidal pattern or absent variability with recurrent late/variable decelerations. Category I includes only clearly reassuring patterns. Scalp pH testing is an option for persistent Category II but not the first step.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.