Early decelerations: Are they really benign?

Early deceleration has been traditionally considered as a benign feature for fetal well-being, as opposed to late and variable decelerations. Several investigators correlated the increased intracranial pressure during labor and delivery with early decelerations. Others argued that if this is the case, early decelerations would have been a consistent feature in all laboring women. Evidence from recent studies paves the way for a plausible explanation for this cardiotocographic pattern. It considers both increased intracranial pressure due to head compression above a specific threshold, and fetal health status. Early deceleration should be considered as a feature of compensated fetalhypoxia and should alert the obstetrician for more close montoring for his/her patient.