July 2013 Moms

Deceleration of fetal heart rate at NST

This may fall under the catergory of a $5.99 question but here goes(I also posted this on the high risk board):I'm wondering if anyone has had fetal heart rate decelerations during an NST (Non stress test)?  I of course googled this topic but I found a lot of medical info. that was a bit confusing.  I was at my bi-weekly NST appointment yesterday and my little one was VERY active.  His baseline heart rate is usually in the 130's but for roughly 1 hour he was constantly moving and his heart rate jumped around from the 160's to the 150's.  The doctor saw 2 decelerations and became very concerned.  She talked about delivering him that night and sent me to L&D for extra monitoring.  I'm 35 weeks with type 2 diabetes.  I wasn't really concerned because it felt logical to me that his heart rate wouldn't be down low if he was so active.  When I was in L&D his heart rate was at a baseline of 130's with great accelerations with movements.  They did an ultrasound and said he was perfect.  Today I just feel a bit concerned but I also have a feeling that the only reason we saw decelerations was because he gets monitored so often and that they may be more common than doctors think or acknowledge.  Does anyone have any experience with decelerations?  
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Re: Deceleration of fetal heart rate at NST

  • Honestly, I really think this might be best asked to your doctor that is monitoring you. 
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  • I can't see your strip and don't really know what your LO was looking like when these decels occurred. It's hard for me to tell you anything about it considering this. What I will say, though, is that different practitioners will tolerate decels differently. I agree with Prim about asking your doctor.

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  • I felt like I really didn't get a straight answer about the decelerations just that they happened and they were concerning but all other signs pointed to him being fine.  I am going to call on Monday and make sure that I don't see that provider again.  I see a team of 4 and she has always been hard to communicate with.  

    I'm hoping someone has had some experience with this happening and can share.     

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  • It sounds like your doctor is watching this very closely. That's definitely key. Decelerations can happen, but it's my understanding that the frequency, length of deceleration, and exactly how low that matters, as well as the whole picture. With my DD, we had a couple of NSTs with a few, short decels they were concerned about, but with longer monitoring and hydration, these resolved. None were more than a few seconds long, and my next NST would be great. It was never a matter of decels that led my OB to deliver her.

    In contrast, when the time came to deliver my DS, he was having extended decels, no good accelerations, and things didn't improve with fluids or putting me on oxygen. Plus we were already dealing with a severe IUGR baby and were aware that my amniotic fluid had been low and the blood flow from the placenta wasn't doing well. Lots of factors. At that point, my doc made the decision to get him out.

    I'm not sure this was helpful or what you were looking for, since you essentially just asked if anyone else had experience, so sorry if it just came across as rambling. It sounds like your doc is doing a good job and was reassured that everything improved when you were monitored longer. I think the important thing is that your OB appears on top of this. Best wishes for a healthy and uneventful remainder to your pregnancy!
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  • image thefuturemrschase:
    I felt like I really didn't get a straight answer about the decelerations just that they happened and they were concerning but all other signs pointed to him being fine. nbsp;I am going to call on Monday and make sure that I don't see that provider again. nbsp;I see a team of 4 and she has always been hard to communicate with. nbsp;I'm hoping someone has had some experience with this happening and can share. nbsp; nbsp;nbsp;


    Definitely ask more questions Monday. Interpreting decels depends on lots of factors, and on your own OB. Again, best wishes and hope you have more clarity Monday.
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  • image valstulas:
    I can't see your strip and don't really know what your LO was looking like when these decels occurred. It's hard for me to tell you anything about it considering this. What I will say, though, is that different practitioners will tolerate decels differently. I agree with Prim about asking your doctor.


    All of this. There are many different types of decels, and some are good, some are bad, and some are very, very bad. Trust your OB, but ask questions whenever you are confused. None of us saw your strip or have any right to interpret its meaning.
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  • image Spartanmomma:
    It sounds like your doctor is watching this very closely. That's definitely key. Decelerations can happen, but it's my understanding that the frequency, length of deceleration, and exactly how low that matters, as well as the whole picture. With my DD, we had a couple of NSTs with a few, short decels they were concerned about, but with longer monitoring and hydration, these resolved. None were more than a few seconds long, and my next NST would be great. It was never a matter of decels that led my OB to deliver her. In contrast, when the time came to deliver my DS, he was having extended decels, no good accelerations, and things didn't improve with fluids or putting me on oxygen. Plus we were already dealing with a severe IUGR baby and were aware that my amniotic fluid had been low and the blood flow from the placenta wasn't doing well. Lots of factors. At that point, my doc made the decision to get him out. I'm not sure this was helpful or what you were looking for, since you essentially just asked if anyone else had experience, so sorry if it just came across as rambling. It sounds like your doc is doing a good job and was reassured that everything improved when you were monitored longer. I think the important thing is that your OB appears on top of this. Best wishes for a healthy and uneventful remainder to your pregnancy!

     

    Thank you so much for sharing your experience.  I find comfort in the fact that this happens to other mothers.   

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  • image Guillerma:
    Trust your OB, but ask questions whenever you are confused. None of us saw your strip or have any right to interpret its meaning.

    Agree. I understand you want some understanding and are feeling really confused (its scary no doubt and that makes sense) but even if our experiences are similar it doesn't mean anything for your particular situation. Please don't look to us to interpret something like that that has major implications for your LO. We can't do that and should not do that. 

    If you want experiences, again, I can tell you during my labor with DD that she had some decels to the point where my midwife/nurses were telling me that they would have to cut me (episotomy) if I didn't make good on the pushing her out. So I was told to "get it done" and quickly. I could see her heart rate was dropping and so thankfully I was able to get it done. If not then I know they would have cut me to get her out. So, that's one version of a decel that sounded really bad. I don't know how bad it was in reality, but bad enough that I remember it. So, its best to trust your doctor and if you don't understand tell them you don't understand.

    What do you think would satisfy you as an answer? Think on it. I'm not trying to be snarky. I'm geniunely asking you to think about what would make you happy to hear. Often, when it comes to things like this there may not be a satisfactory answer that will please you, you just have to trust your medical professionals to take care of you and baby. 

    So, I get that you are confused and want answers, but we (as internet strangers) are not the ones to give it to you. Your doctor needs to do that.  

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  • image PrimRoseMama:

    image Guillerma:
    Trust your OB, but ask questions whenever you are confused. None of us saw your strip or have any right to interpret its meaning.

    Agree. I understand you want some understanding and are feeling really confused (its scary no doubt and that makes sense) but even if our experiences are similar it doesn't mean anything for your particular situation. Please don't look to us to interpret something like that that has major implications for your LO. We can't do that and should not do that. 

    If you want experiences, again, I can tell you during my labor with DD that she had some decels to the point where my midwife/nurses were telling me that they would have to cut me (episotomy) if I didn't make good on the pushing her out. So I was told to "get it done" and quickly. I could see her heart rate was dropping and so thankfully I was able to get it done. If not then I know they would have cut me to get her out. So, that's one version of a decel that sounded really bad. I don't know how bad it was in reality, but bad enough that I remember it. So, its best to trust your doctor and if you don't understand tell them you don't understand.

    What do you think would satisfy you as an answer? Think on it. I'm not trying to be snarky. I'm geniunely asking you to think about what would make you happy to hear. Often, when it comes to things like this there may not be a satisfactory answer that will please you, you just have to trust your medical professionals to take care of you and baby. 

    So, I get that you are confused and want answers, but we (as internet strangers) are not the ones to give it to you. Your doctor needs to do that.  



    I'm mobile and have no idea how to do a thumbs up, but this was exactly what I was hoping to get across. I hope that hearing our stories gives you comfort that you're not alone, but no one else's experiences can reflect or explain your own, or should be used as medical advice. Talk with your OB Monday, maybe even have them show you the NST strip and what everything on them means. They're actually somewhat interesting. Best wishes and hope you have a relaxing weekend OP and others. c:
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  • image thefuturemrschase:

    I felt like I really didn't get a straight answer about the decelerations just that they happened and they were concerning but all other signs pointed to him being fine.  I am going to call on Monday and make sure that I don't see that provider again.  I see a team of 4 and she has always been hard to communicate with.  

    I'm hoping someone has had some experience with this happening and can share.     

    I'm sorry that doctor didn't really give you the answers you were looking for.  I've been pregnant five times, been seen in two different practices, and have had four different OBs/MWs.  Plus I work with OBs and MWs on a daily basis.  Some providers you just connect better with.  It sounds like you and this particular OB don't click well.  Do what you have to do, and if you need to request someone else from now on so you can better understand your care, that's what you need to do. 

    Definitely call on Monday and ask to talk to your regular doctor.  It may be helpful to have a specific list of questions in hand if you have any in mind. 

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  • They way the nurse explained in to me about deceleration is that it means the baby may be sticking its little hand on the umbilical cord. Do you know how far it decelerated?
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  • "Often, when it comes to things like this there may not be a satisfactory answer that will please you," Prim

    I think this hit the nail on the head.  I am feeling confused and a bit concerned.  I shouldn't let nerves get the better of me.   

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  • image valstulas:
    image thefuturemrschase:

    I felt like I really didn't get a straight answer about the decelerations just that they happened and they were concerning but all other signs pointed to him being fine.  I am going to call on Monday and make sure that I don't see that provider again.  I see a team of 4 and she has always been hard to communicate with.  

    I'm hoping someone has had some experience with this happening and can share.     

    I'm sorry that doctor didn't really give you the answers you were looking for.  I've been pregnant five times, been seen in two different practices, and have had four different OBs/MWs.  Plus I work with OBs and MWs on a daily basis.  Some providers you just connect better with.  It sounds like you and this particular OB don't click well.  Do what you have to do, and if you need to request someone else from now on so you can better understand your care, that's what you need to do

    Definitely call on Monday and ask to talk to your regular doctor.  It may be helpful to have a specific list of questions in hand if you have any in mind. 

    This!  And what Prim and other PPs have said - interpreting electronic fetal monitoring (EFM) strips is very tricky. Some decels are expected and others can be indications that something is wrong or headed in that direction. The big problem with EFM is the wide variability in interpretation both between different providers *and* at different times by the same provider. It's just not yet a perfect technology.

    Best of luck on Monday! Try to be reassured by the overall impression of your caregivers, and certainly speak up if you feel a particular provider is better at communicating with you.

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