Late decelerations in fetal heart rate most strongly indicate which condition?

• A. Uteroplacental insufficiency
• B. Cord prolapse
• C. Fetal tachycardia
• D. Maternal fever

Answer: (A)

Late decelerations signal that the fetus is experiencing hypoxia due to reduced placental perfusion, i.e., uteroplacental insufficiency. They peak after the start of a contraction and continue to occur as contractions persist, reflecting that the placenta isn’t delivering enough oxygen to the fetus during times of increased demand. This pattern points to issues with placental blood flow or maternal factors that lower it.

Cord prolapse typically causes abrupt, variable decelerations from cord compression, not the gradual, post-peak pattern of late decels. Fetal tachycardia is a fast baseline heart rate and doesn’t describe a deceleration pattern. Maternal fever can accompany distress and may cause fetal tachycardia, but it doesn’t produce late decelerations as a primary finding.