Differential Diagnosis for 35 Weeks Pregnancy with Late Decelerations
Single Most Likely Diagnosis
- Uteroplacental Insufficiency: This is the most likely diagnosis, as late decelerations are a classic sign of uteroplacental insufficiency, where the placenta is not functioning properly, leading to fetal distress.
Other Likely Diagnoses
- Fetal Growth Restriction (FGR): FGR can cause late decelerations due to the fetus not receiving enough oxygen and nutrients.
- Preeclampsia: Preeclampsia can cause uteroplacental insufficiency, leading to late decelerations.
- Placental Abruption: Placental abruption can cause fetal distress, leading to late decelerations.
Do Not Miss Diagnoses
- Umbilical Cord Compression: Although less likely, umbilical cord compression can cause late decelerations and is a potentially life-threatening condition if not promptly addressed.
- Fetal Anemia: Fetal anemia can cause fetal distress, leading to late decelerations, and is a critical condition that requires immediate attention.
Rare Diagnoses
- Fetal Congenital Anomalies: Certain fetal congenital anomalies, such as cardiac anomalies, can cause fetal distress, leading to late decelerations.
- Maternal Medical Conditions: Certain maternal medical conditions, such as chronic hypertension or renal disease, can increase the risk of uteroplacental insufficiency and late decelerations.
Management
Management of late decelerations in a 35-week pregnancy involves close monitoring of the fetus, including:
- Continuous fetal heart rate monitoring
- Biophysical profile (BPP) assessment
- Umbilical artery Doppler assessment
- Fetal movement counting
- Consideration of immediate delivery if the fetus is in distress or if the mother's condition worsens.