Fetal distress may occur during active labor, and care must be taken to evaluate the fetal status as often as possible. Indicators of fetal distress include decelerations in fetal heart rate. This is defined as a persistent drop in fetal heart rate during contractions persisting more than 30 s after a contraction. While many EDs do not have fetal monitoring devices, Doppler heart tones should be measured after each contraction to detect the presence of decelerations. Episodic bradycardia persisting for more than 5 min is an indication for immediate cesarean section.
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