In today’s educational video we are going to discuss deceleration patterns and HIE from a medical legal standpoint. For some parents that we talk to, oxygen related issues are not brought up a lot during pregnancy and labor and delivery. Although it is a given that we need oxygen to survive, understanding how certain things during labor and delivery can shed light on oxygen related problems can help families get a better picture of the areas of investigation when attempting to understand could their baby’s brain injury have been prevented.

At the conclusion of this article, you will understand why certain patterns on the fetal heart monitor can suggest problem for your baby. Although the fetal heart monitor is not the end all be all in an investigation into a HIE injury at birth, the device does help one get a picture of how well a baby was tolerating the vaginal delivery.



The fetal heart monitor is used in hospitals all over the United States. One feature of the monitor is to help doctors and nurses determine how well a baby might be dealing with a vaginal delivery. Mom may have noticed a device on her abdomen, as this is how the monitor can deliver the readings.

There are a host of readings that the monitor displays. For example, it can tell doctors and nurses the status of your baby’s heart rate. Depending on the literature, the heart rate should be between 120-160 beats per minute. Understanding how fast or slow the baby’s heart rate is important for doctors and nurses to understand.

In addition, the monitor can help with things like variability and contraction patterns, among other things. A mother’s contraction patterns are also important because tachysystole is a condition that can develop.



Decelerations patterns and HIE is something many parents are not too familiar. For this section I am going to discuss two type of deceleration patterns, early and late.

Early decelerations are a type of pattern that can be reported by the electronic fetal heart monitor. An early deceleration pattern will cause a slight drop in the baby’s heart rate. With that said the onset occurs BEFORE the contraction peak. In addition, the pattern will mirror the contraction pattern. Early decelerations are sometime referred to as a type of benign finding and will require continued monitoring of the fetal heart tracings.

Late decelerations, especially repeated, are more serious. Like an early deceleration, the fetal heart rate will drop a little. However, the onset will occur with or AFTER the contraction peak and recovery to the baseline occurs after the contraction ends.

An issue late decelerations can reveal is oxygen related problems for the baby. HIE, or hypoxic ischemic encephalopathy in its basic form is a reduced level of blood and oxygen, which can cause a brain injury. When repetitive late decelerations are present, it is these types of oxygen related injuries that must be guarded against. Doctors must be ready to move to an emergency C-section when warranted because failure to do so in some cases can lead to serious injury for the baby.



If you have questions regarding what happened surrounding your baby’ HIE or CP diagnosis this is what I invite you to do. Pick up the phone and call me. I talk with families all the time regarding these issues and I would be happy to listen to your baby’s story.


You can reach me at 301-850-4832.


Marcus B. Boston, Esq.

Boston Law Group, LLC

2 Wisconsin Circle, Suite 700

Chevy Chase, Maryland 20815


1-833-4 BABY HELP

Marcus Boston is a Maryland medical malpractice attorney who helps people navigate the Maryland childbirth injury and medical malpractice process to get money for their injuries caused by the carelessness of doctors and hospitals. BLG handles cases in Prince George’s County, Baltimore City, Montgomery County, Howard County, Anne Arundel County, and all other Maryland Counties. blgesq Maryland birth injury attorneys