A 35 year old chronic hypertensive mother with 34 weeks of gestation is done a biophysical profile. The presence of severe oligohydramnios in a patient with intact membranes and no evidence of fetal renal anomalies is evidence of chronic hypoxia. In the case of severe oligohydramnios, continuation of pregnancy will not improve pregnancy outcome but rather increase the chances of hypoxic injury to the fetus who would not be able to respond to new acute hypoxic insults. At this Gestational age, delivery is appropriate. A 20 year old mother complains of decreased fetal movements in the last 24 hours.
Fetal movements are a good monitoring technique that involves the patient.
However, in most instances of reported decreased fetal movements, this is a false positive finding. In these cases, a more reliable test, such as the biophysical profile, should be done. However, the possibility of fetal hypoxia exists and therefore this complaint should be taken seriously and evaluated immediately. During a non-stress test done at 30 weeks in a diabetic mother with intact membranes and normal amount of amniotic fluid, a severe variable deceleration is documented. After a period of decreased variability lasting 4 minutes, the fetal tracing returns to normal with frequent fetal heart rate accelerations.