Decels during NST?

[Lana23]

I those are worrisome findings?
I know that I shouldn't ask ur opinion about my personal issues,but I would like to know something more about variable decelerations if u don't mind

Every time I went in for monitoring the HR dropped lower than the baseline for 5 seconds aprox.The last time it went down to 115 from 120-135 32 times.
All of the doctors and nurses ignored my concern about the HR drops even tho they happen every time i have NST or simple monitoring of the HR.

I just want to know if i should insist to have any further monitoring or it's a normal finding?
A million thanks

[AllyRae]

Everyone's heart will decel when they are resting or inactive, including an unborn child's. The most important finding is did the heartrate accelerate during movement?

[Lana23]

Originally Posted by AllyRae

Everyone's heart will decel when they are resting or inactive, including an unborn child's. The most important finding is did the heartrate accelerate during movement?

I know that the HR decreases when the baby's not active,but i thought that the drop from the baseline all the sudden is worrisome =/

The baby was moving a LOT and yes,the HR was accelerating perfectly,i was told.Once she become more calm and the HR dropped to 120-140 max,was when it dropped down to 115 for few seconds.
Thanks for the replay.

[AllyRae]

I'm trying to think back to when I had NSTs with DD2...I was high risk with her (like really really high risk for stillbirth, etc. with her) and had NSTs twice a week for the entire 3rd trimester. I know she had decels, but I don't think anyone ever thought twice about them, except when she wouldn't accelerate again (that's when they used the little buzzer thing to wake her up). The one time they kind of wigged was when she dropped below 100 for a few seconds...then they wisked me over for an ultrasound.

ETA: I would definitely have them keep an eye on it, for sure. But as long as it wasn't sustained that low for a minute or so, I don't think there would be a big problem as long as she also had good accels too...

[jengacnm]

It's not a deceleration unless it's 15 seconds or more, and unless the drop is 15 beats or more. So, if the baseline is 120-135, it would need to drop to 105 or less for 15 or more seconds.

Hope that helps!

Jen

[Sijae]

Originally Posted by jengacnm

It's not a deceleration unless it's 15 seconds or more, and unless the drop is 15 beats or more. So, if the baseline is 120-135, it would need to drop to 105 or less for 15 or more seconds.

Hope that helps!

Jen

Yep, going down and up like that is not decels it's normal variability. Variability is great and is what you want to hear. It means your baby is doing well. Babies with a flat heart rate are in real trouble.

Laura

[MsBlack]

A normal heartbeat varies....it should not sound exactly the same all the time, even if the baby remains at rest--which means it would not 'look' the same all the time on the monitor. "Flatline" refers to the monitor printout--if the baby's heart has no variability, you would see a straight, flat line instead of a line that meanders up and down a little bit at rest, and has more distinct peaks and valleys during movement and return to rest.

[birthangeldoula]

My daughters heart rate used to do the same thing during my nst's. It freaked me out. The doc reassured me that it was normal..
She's 10 months old today and is a happy healthy baby.

[katelove]

Short decels which go beyond normal variability can also be "cord kicks". Well, that's what we call them in Australia, they are actually thought to be brief cord compression from the baby squeezing the cord, the cord being squeezed between the head and the uterine wall etc. On the trace it looks like the line goes straight down and straight back up again, like a double line, with little or no space between the down stroke and the up stroke. They are normal and nothing to be concerned about

[Lana23]

Thanks for all the replays

Originally Posted by katelove

Short decels which go beyond normal variability can also be "cord kicks". Well, that's what we call them in Australia, they are actually thought to be brief cord compression from the baby squeezing the cord, the cord being squeezed between the head and the uterine wall etc. On the trace it looks like the line goes straight down and straight back up again, like a double line, with little or no space between the down stroke and the up stroke. They are normal and nothing to be concerned about

I thought it's due to cord compression but what i wasn't sure is if it means that the cord is compressed all the time or just temporary?
I know she might have nuchal cord, but during the contractions i was having few days ago,the hr wasn't dropping.

[katelove]

Originally Posted by Lana23

Thanks for all the replays



I thought it's due to cord compression but what i wasn't sure is if it means that the cord is compressed all the time or just temporary?
I know she might have nuchal cord, but during the contractions i was having few days ago,the hr wasn't dropping.

With "cord kicks" the decel reflects the cord compression. When the compression is released the heartbeat goes back up. A nuchal cord wouldn't cause "cord kick" decels although it is accociated with variable decels sometimes.

The following website has some good info (with pics) about the different types of decels and their common causes although, unfortunately it doesn't show "cord kicks". It talks about variable decels which are also caused by cord compression but last longer than "cord kicks"

http://www.childbirths.com/cypress/f...itoringetc.htm

[Lana23]

Originally Posted by katelove

With "cord kicks" the decel reflects the cord compression. When the compression is released the heartbeat goes back up. A nuchal cord wouldn't cause "cord kick" decels although it is accociated with variable decels sometimes.

The following website has some good info (with pics) about the different types of decels and their common causes although, unfortunately it doesn't show "cord kicks". It talks about variable decels which are also caused by cord compression but last longer than "cord kicks"

http://www.childbirths.com/cypress/f...itoringetc.htm

Thanks for the link
So,if i understood correctly,the if the decels were caused by the nuchal cord,if it was too tight for instance, then the decels would last longer??the one i was speaking of,do they sound to u that were caused by the nuchal cord?
Thanks again

[katelove]

If the decels you were having were like the ones I initially described - double line, straight up and down sort - then no, it doesn't sound to me like that would be caused by a nuchal cord. It sounds more like the baby was squeezing the cord with it's hand or compressing it against the wall of your uterus with a head or knee or something. A very quick squeeze and release.

If they look more like the variable decels in the pic on the website then they could be being caused by the nuchal cord if the baby was moving in a way which pulled the cord tight around his/her neck.

ETA - just re-read your original post. A drop of 5-10 beats is just normal variability, as PPs have said, which is a key sign of foetal wellbeing. You don't want babe's heartbeat to be steady on one number.

I don't suppose you've got a copy of the trace? It's really hard to describe all the features of a CTG without visual aids

[katelove]

http://images.google.com.au/imgres?i...a%3DX%26um%3D1

Ok, I found a picture. See that thick line that goes down to 120? That's a "cord kick"

[Lana23]

Originally Posted by katelove

http://images.google.com.au/imgres?i...a%3DX%26um%3D1

Ok, I found a picture. See that thick line that goes down to 120? That's a "cord kick"

Thanks a lot
I didn't get to see it on the chart,i just saw the number,but i think that it took bit more time to go up to the baseline than on the pic u showed me.
Like i said it was few seconds.It's tought to describe tho but it looked more like the other pic on the website.Something between? hehe

[katelove]

I'm guessing it's all normal but it really annoys me when HCPs don't explain things properly and their patient gets to go hame and stress about it

Do you feel comfortable pinning them down next time you're there and getting them to explain each component of the trace? With the trace there in front of you both? The discussion should include - baseline, variability, accelerations, decelerations and a conclusion about whether the trace is reassuring or non-reasuring.

[Lana23]

Originally Posted by katelove

I'm guessing it's all normal but it really annoys me when HCPs don't explain things properly and their patient gets to go hame and stress about it

Do you feel comfortable pinning them down next time you're there and getting them to explain each component of the trace? With the trace there in front of you both? The discussion should include - baseline, variability, accelerations, decelerations and a conclusion about whether the trace is reassuring or non-reasuring.

The doctor didn't even see the tracing.It's up to the nurses to decided if they show it to the doctor or not.According to them everything was perfect.I did ask the doctor about the decels and he said no worries it's normal.At the moment i was ok with his answer but once i got home i was like how come he knew it's normal when he only saw the nurse's notes?I assume that the nurses see million of tracing like this,much more than the doctors,at least at this hospital,so i hope everything will be fine.
I'm seeing my doctor tomorrow and i will ask to have the baby
s HR monitored more often since she has nuchal cord.I know he will say there is no reason to worry, but i will insist.
Wish me luck

[katelove]

All the best! And, if you have any concerns, ask to see the trace and have it explained to you. If the nurse is capable of monitoring your baby and writing notes on the trace then he/she should be capable of explaining it to you.