Variable Decelerations Prolonged Deceleration

o Visually apparent abrupt decrease in FHR
o AN abrupt FHR decrease is defined as from the
onset of deceleration to the beginning of the
FHR nadir less than 30 seconds
o The decrease in FHR is calculated from the
onset to the nadir of deceleration
o The decrease in FHR is 15 beats per minute or
greater, lasting 15 seconds or greater and less
than 2 minutes in duration
o Visually apparent decrease in FHR below the
baseline
o Decrease FHR from the baseline that is 15
beats per minute or more, lasting 2 minutes or
more but less than 10 minutes in duration
o If a deceleration last 10 minutes or longer, it is
a baseline change
Sinusoidal Pattern
o Visually apparent, smooth, sine wave-like
undulating pattern in FHR baseline with a cycle
frequency of 3-5 per minute which persist for
20 minutes or more
o Appears like a saw tooth pattern. Is ominous for
fetal compromise

Late Deceleration
o Visually apparent usually symmetrical gradual
decrease and return of the FHR associated with
a uterine contraction
o A gradual FHR decrease is define as from the
onset to the FHR nadir of 30 seconds or more
o The decrease in FHR is calculated from the
onset to the nadir to the deceleration
o The deceleration is delayed in timing, with the
nadir of the deceleration occurring after the
peak of the contraction
NORMAL/Reactive NST BIOPHYSICAL PROFILE (BPP)
Baseline 110-160 bpm Component Criteria
Variability 6-25 bpm Breathing At least one episode continuing for
<= 5(absent or minimal) for 40 mins Movements more than 30 sec
Decelerations None or occasional variable < 30 sec Movements At least three body or limb
Acceleration: 2 accelerations with acme >= 15 bpm, movements
Term Fetus lasting 15 sec in <40 min of testing Tone An active extension with return to
Acceleration: 2 accelerations with acme >= 10 bpm, flexion of the limbor trunk, OR
Preterm Fetus lasting 10 sec in < 40 min of testing opening and closing of the hand
<32wks Amniotic fluid At least one cord or limb free pocket
Action Further assessment OPTIONAL, base volumes which is 2cm x 2cm on 2
on total clinical picture measurement at tight angles

ATYPICAL NST
Previously “non-reactive”
Baseline 100-110 bpm
160 bpm for 30 min
Rising baseline
Variability <= 5(absent or minimal) for 40-80
mins
Decelerations Variable decelerations of 30-60 sec
Acceleration: 2 accelerations with acme >= 15 bpm,
Term Fetus lasting 15 sec in 40-80 min of testing
Acceleration: 2 accelerations with acme >= 10 bpm,
Preterm Fetus lasting 10 sec in 40-80 min of testing
<32wks
Action Further assessment is REQUIRED

ABNORMAL NST
Previously “non-reactive”
Baseline Bradycardia: 100 bpm
Tachycardia: 160 bpm for 30 min
Erratic baseline
Variability <= 5(absent or minimal) for >=
80mins
>25 bpm for 10 min
Sinusoidal
Decelerations Variable decelerations for 60 sec
Laye deceleration
Acceleration: 2 accelerations with acme >= 15 bpm,
Term Fetus lasting 15 sec in 80 min of testing
Acceleration: 2 accelerations with acme >= 10 bpm,
Preterm Fetus lasting 10 sec in 80 min of testing
<32wks
Action URGET ACTION REQUIRED