Decels
Formal Definition
Short for decelerations; periodic or episodic decreases in fetal heart rate from baseline, classified as early (mirror contractions — head compression), variable (abrupt onset — cord compression), or late (gradual onset after contraction peak — uteroplacental insufficiency), each with distinct clinical significance.
How It's Used on the Ward
"Having decels" or "late decels on the strip" — nursing and obstetric team shorthand for watching the fetal heart rate tracing for concerning patterns.
Example
""Nursing calling: patient is having repetitive late decels down to the 90s after each contraction with minimal variability. Repositioned her to left lateral, oxygen on, bolusing fluids, stopping oxytocin. OB at bedside now.""
Clinical Context
Early decels: nadir coincides with contraction peak, gradual onset and return, head compression — benign. Variable decels: abrupt, V or U shaped, variable timing relative to contractions, cord compression — concerning if persistent, severe (< 70 bpm), or prolonged (> 60 sec). Late decels: gradual onset after contraction peak, nadir after acme — sign of uteroplacental insufficiency, concerning even if shallow. First-line response: maternal repositioning, O2, IV fluids, stop oxytocin, assess for cord prolapse.
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