Background: This report describes the fetal heart rate (FHR) tracing in a pregnancy complicated by antenatal spontaneous rupture of fetal vessels on the placental surface that resulted in a live birth.
Case: 36-year-old woman, G2P1001, was being followed with weekly antenatal testing for gestational diabetes type A2 on insulin with possible intrauterine growth restriction. She presented for an office visit at 37.5 weeks' gestation with a complaint of decreased fetal movement. The FHR pattern demonstrated minimal baseline variability with an occasional spontaneous deceleration not associated with a contraction, an absence of recurrent decelerations, and no accelerations. The antenatal evaluation is discussed, and portions of the FHR tracing and the placental findings at delivery are provided.
Conclusion: The FHR pattern did not fit with what is usually depicted with uteroplacental insufficiency or umbilical cord entrapment. In addition, even though the fetus is anemic, the process may occur too quickly for a sinusoidal pattern to develop.