North American Registry of Midwives (NARM) Practice Exam

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What causes early decelerations in fetal heart tones?

Uteroplacental insufficiency
Cord compression
Head compression
Maternal hyperventilation

The correct answer is: Head compression

Early decelerations in fetal heart tones are primarily caused by head compression during labor. This phenomenon occurs when the fetal head exerts pressure on the cervix or pelvic structures. As the head compresses these structures, it stimulates the vagus nerve, which in turn leads to a transient decrease in the fetal heart rate. Early decelerations are typically characterized by their gradual onset and return to baseline, mirroring the contractions that lead to this compression. This understanding is crucial for midwives and healthcare professionals monitoring labor, as it indicates that the fetus is likely tolerating labor well, and the decelerations are not associated with fetal distress. Recognizing this type of deceleration helps to differentiate it from other forms that may indicate more severe issues, such as uteroplacental insufficiency or cord compression.