Master Early Decelerations with Picmonic for Nursing RN

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Decelerations (and Accelerations) Overview

Late Decelerations

Variable Decelerations

Mechanism of Labor

Induction of Labor

Early Decelerations

Early-sun with Decelerating fetus heart

Picmonic

Decelerations which are caused by a parasympathetic response during labor can be benign in nature (a normal pattern occurrence) or can be abnormal or nonreassuring. They are identified visually on a fetal monitor tracing by when they occur in the contraction cycle either the onset or at the end of a contraction and also by their shape. An early deceleration is identified as a gradual decrease (onset to lowest point is ≥ 30 seconds) in fetal heart rate with return to the baseline associated with a contraction.

6 KEY FACTS

Fetal head compression is the most common cause of an early deceleration that occurs during labor as the fetal head advances in the birth canal.

Often during the first stage of labor (cervix dilated 4 to 7cm), an early deceleration can occur while the uterus is contracting.

The process of inserting an internal fetal monitor probe can lead to fetal head compression.

During a vaginal exam, the presenting part is palpated which can lead to transient fetal head compression.

Applying external pressure on the laboring mother’s abdomen is one mechanism that causes fundal pressure and fetal head compression, which leads to an early deceleration.

An early deceleration is not associated with fetal hypoxemia, acidemia, or low Apgar scores. Consequently, there is no nursing intervention required other than continued monitoring.

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