Cardiotocography in a woman at 39 weeks in spontaneous labour shows recurrent decelerations that begin after the peak of the contraction and recover after the contraction ends. The baseline variability is normal and there are no accelerations or variable decelerations. This pattern most strongly suggests which mechanism?

• A Cord compression around the neck or body
• B Head compression during the second stage
• C Fetal sleep cycle producing a benign pattern
• D Uteroplacental insufficiency causing fetal hypoxaemia ✓

Explanation

Late decelerations start after the contraction peak and return to baseline after it ends. They reflect hypoxaemia from reduced uteroplacental perfusion during contractions and, when recurrent, indicate fetal distress requiring evaluation and possible expedited delivery. Early decelerations mirror the contraction and reflect head compression, while variable decelerations that dip abruptly and recover quickly indicate cord compression.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.