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All tables are from Parer and Ikeda, AJOG 2007

 

TABLE 5:  Risk categories for fetal acidemia related to FHR variability, baseline rate and presence of recurrent decelerations 

 

MODERATE (NORMAL) VARIABLILTY

 No     Early   Mild VD  Mod VD Sev VD Mild LD Mod LD Sev LD Mild PD Mod PD Sev PD  
Tachy
NormalGGGBYYYYYO
Mild Brd      YYYYOYYOYYO
Mod Brd  YY  O OO  O
Sev BrdOO     O  O  O

 

 

MINIMAL VARIABILITY 

 No     Early   Mild VD  Mod VD Sev VD Mild LD Mod LD Sev LD Mild PD Mod PD Sev PD  
TachyOOOOR
NormalBBYOOOROOR
Mild Brd      OORRRRRRRRR
Mod Brd  OO  R RR  R
Sev BrdRR     R  R  R

 

 

ABSENT VARIABILITY 

 No     Early   Mild VD  Mod VD Sev VD Mild LD Mod LD Sev LD Mild PD Mod PD Sev PD  
TachyR R  R  R RRRRRR
NormalORRRRRRRRR
Mild Brd      RRRRRRRRRRR
Mod Brd  RR  R RR  R
Sev BrdRR     R  R  R

   

Sinusoidal R
Marked VariabilityY

 
VD = variable deceleration
LD = late deceleration
PD = prolonged deceleration
Brd = bradycardia
Tachy = tachycardia
G= green; B=blue; Y=yellow; O=orange; R=Red 
 
 
Table 4:  Proposed management of the color-coded categories  (will vary depending on institution). 
 
 

Conservative

techniques 

Operating

Room 

 ObstetricianAnesthestist 

Newborn

Resuscitator 

Location of

Patient 

 Green   No - - - - -
 Blue YesAvailable Informed   
 Yellow YesAvailable At bedside Informed  Informed 
 Orange Yes

Immediately

Available 

 At bedside  Present

 Immediately 

 Available 

OR
 Red YesOpen At bedside Present  Present OR

 
Table 2:  Risk of acidemia, evolution to a more serious pattern, recommended action  
 
 Risk of acidemia Risk of evolution  Action
 Green     0 Very low None
 Blue 0 Low CT and begin preparation 
 Yellow 0 Moderate CT and increased surveillance 
 Orange Borderline/acceptaby low High CT and prep for urgent delivery
 Red Unacceptaby high Not a consideration Deliver

CT = conservative techniques:
Position change
Hyperoxia
Correct hypotension
Adequate intravascular volume
Correct excessive contractions (e.g. decrease oxytocin)
Avoid constant pushing
Tocolysis
Amnioinfusion to correct amniotic fluid deficit