title: Clinical associations of variable decelerations during reactive nonstress tests.
abstract: Six hundred ninety-three patients at or beyond 30 weeks' gestation with reactive nonstress tests (NSTs) were divided into groups based on the occurrence of variable decelerations of 15 seconds or more in duration and of 20 or more beats per minute in severity. Ultrasound examination within a month of testing showed no increases in nuchal cord localization or decreased amniotic fluid volumes in a subgroup of 181 patients. Fetuses with antepartum variable decelerations were more likely to demonstrate similar decelerations in labor (P less than .001), to undergo operative delivery for a diagnosis of "distress" (P less than .05), to require intensive care nursery admission (P less than .01), and to be small for gestational age (P less than .01). No significant differences were noted in frequency of nuchal or other cord entanglements, overall cesarean section rate, or low pH or Apgar score values. We conclude that variable decelerations in the absence of other alarming NST findings may aid in identifying patients at risk for adverse perinatal occurrences, although factors other than nuchal cord placement or oligohydramnios may be responsible.
authors.affiliation: Department of Obstetrics and Gynecology, Case Western Reserve University/Cleveland Metropolitan General Hospital, Ohio.
authors.forename: N E
authors.initials: NE
authors.lastname: Judge
authors.forename: L I
authors.initials: LI
authors.lastname: Mann
authors.forename: P
authors.initials: P
authors.lastname: Lupe
authors.forename: S
authors.initials: S
authors.lastname: Amini
mesh_terms: D000653:Amniotic Fluid; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D014463:Ultrasonography; D014470:Umbilical Cord / Q000503:physiopathology