A CTG shows decelerations that vary in timing and shape relative to contractions. Which single cause do these variable decelerations most often indicate?

Answer: D. Cord compression

Variable decelerations

Variable decelerations

• They vary in timing, shape and depth relative to contractions.
• They most often indicate cord compression.

Management

• Change maternal position to relieve cord compression; assess the overall trace.
• If variable decelerations become deep, prolonged or are associated with reduced variability/late features, escalate (fetal scalp blood sampling, expedited delivery).

Contrast

• Early decelerations = head compression (normal); late = uteroplacental insufficiency (pathological).

So variable decelerations most often indicate cord compression.