For a laboring patient, which fetal heart rate change is concerning?

Late decelerations are concerning during labor because they indicate potential fetal distress, specifically issues with uteroplacental perfusion. These decelerations occur after a contraction has started and usually return to baseline after the contraction ends, suggesting that the fetus may not be receiving adequate oxygen due to compromised blood flow through the placenta.

In contrast, moderate variability is considered a reassuring sign, as it reflects a well-functioning nervous and cardiovascular system in the fetus. Early decelerations are often benign and associated with fetal head compression during contractions, which is a normal occurrence in labor. Variable decelerations can indicate umbilical cord compression but do not always suggest immediate distress; their significance often depends on the pattern and context.

Overall, the presence of late decelerations in a laboring patient requires close monitoring and may necessitate intervention to ensure the safety and well-being of the fetus.