Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Review

Volume 10, Number 4, April 2018, pages 302-308

Obstetrics at Decisive Crossroads Regarding Pattern-Recognition of Fetal Heart Rate Decelerations: Scientific Principles and Lessons From Memetics

Figures

Figure 1.
Figure 1. Direct empirical evidence showing transabdominal pressure on fetal head causes short lasting rapid FHR decelerations which are suppressed after atropine administration in human labor (gratefully reproduced with kind permission from Mendez-Bauer et al [12])
Figure 2.
Figure 2. Direct empirical evidence showing pressure on posterior fontanelle with a finger introduced in vagina causes short lasting rapid FHR decelerations which are suppressed after atropine administration in human labor (gratefully reproduced with kind permission from Mendez-Bauer et al [12]).
Figure 3.
Figure 3. (a) Schematic drawing of FHR deceleration resulting from peripheral chemoreflex due to hypoxemia based on scientific rationale. Hypoxemic trigger is very likely to produce a classical “late deceleration” [9]. Shaded area: level of IUP where fetal PaO2 will continue to drop during deceleration; Point A: contraction commences; B: IUP enough to commence fetal hypoxemia; C: worsening fetal hypoxemia enough to start FHR deceleration; D: peak of contraction where speed of worsening of hypoxemia will slow down but hypoxemia will continue to worsen (PaO2 continues to drop); E: hypoxemia will continue to worsen; F: hypoxia will start recovering because IUP equivalent to point B. Chemoreflex induced FHR deceleration will start recovering at point F and recovery will extend beyond the end of contraction. FHR: fetal heart rate; IUP: intrauterine pressure; PaO2: fetal partial pressure of oxygen. (b): Schematic drawing showing that the common rapid short-lasting FHR decelerations in labor cannot be explained by fetal hypoxemia.