VBAC

Heart Decels, Labor & VBAC

When I was in labor during my VBAC attempt, DS2 was having decels for several  hours before we finally decided to do the c/s.  My doctors were very patient and did everything that they could to lessen the decels. I remember at one point the nurse told me that they could tell that they were fairly certain that the decels were because DS2 either had the cord around his neck fairly tight or he was laying on the cord and not due to any issues with my uterus.  She said that they could tell because of the type of decels but didn't elaborate.  During my c/s, the doctor confirmed that my uterus was in great shape and indeed the decels were a cord related issue.

So my question, does anyone know what kind of decels indicate cord issues vs uterine rupture?  I tried to do some research and I found that cord issues tend to have variable decels but I am finding mixed messages about uterine rupture decels.

Thanks ladies!

Re: Heart Decels, Labor & VBAC

  • I *think* (and I'll keep looking and correct myself if needed) that decels related to cord issues will either be variable decels (not correlated with contractions) that come back to baseline quickly, or will be decels with each contraction. Decels related uterine rupture will be prolonged and will not return to baseline with position change, end of contraction, maternal oxygen administration, etc. The key is coming back to baseline quickly.
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  • Here's what I found in the New Mexico Midwive's Assoc. websitehttps://nmhealth.org/PHD/midwife/NMMA%202008%20practice%20guidelines.pdfp. 93:

    1. Fetal tachycardia with minimal variability 
    2. Repetitive late decelerations followed by bradycardia, or loss of heart tones

    3. Violent fetal movement followed by decreased or no fetal activity Practice Guidelines for NM Midwives ? June 2008  160 

    And from p. 159:

     Continually assess for symptoms of uterine rupture.  1. The most common, and sometimes only, sign of uterine rupture is a non-reassuring fetal heart rate pattern  2.  FHT decelerations or abnormal pattern 3. Sudden, severe, tearing; unusual pain 4. Frank, bright red bleeding 5. Loss of uterine contractions or tonus 6. Signs or symptoms of shock 

    7. Uncontrolled postpartum bleeding  

    Hope that helps. 

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  • imagehonkytonk_kid:
    I *think* (and I'll keep looking and correct myself if needed) that decels related to cord issues will either be variable decels (not correlated with contractions) that come back to baseline quickly, or will be decels with each contraction. Decels related uterine rupture will be prolonged and will not return to baseline with position change, end of contraction, maternal oxygen administration, etc. The key is coming back to baseline quickly.

    THANK YOU!  This is what I was finding too, but some sites were calling uterine rupture decels "variable" while others were saying what you are about the prolonged decels.

  • imagehonkytonk_kid:
    I *think* (and I'll keep looking and correct myself if needed) that decels related to cord issues will either be variable decels (not correlated with contractions) that come back to baseline quickly, or will be decels with each contraction. Decels related uterine rupture will be prolonged and will not return to baseline with position change, end of contraction, maternal oxygen administration, etc. The key is coming back to baseline quickly.

    This is what I have found in some of my research too, but it is hard to find much information on it! 

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