Presentation : Fetal distress

By:Nafisa Hassan

9/3/2023
Objectives:
1) Definition of fetal Distress
2) Causes of fetal distress
3) Sign and sypmtoms
4)Types of Fetal distress
5) Risk factors of fetal distress
6) How do you monitor fetal distress?
7) Management of fetal distress
8) Prevention of fetal distress
9) Complications of fetal distress
 Definition of fetal Distress

Fetal distress, also known as non-reassuring fetal status, is a condition during pregnancy or labor in which the fetus shows

signs of inadequate oxygenation. Due to its imprecision, the term "fetal distress" has fallen out of use in American

obstetrics The term "non-reassuring fetal status" has largely replaced it. It is characterized by changes in fetal movement,

growth, heart rate, and presence of meconium stained fluid.

Risk factors for fetal distress/non-reassuring fetal status include anemia, restriction of fetal growth, maternal hypertension or

cardiovascular disease, low amniotic fluid or meconium in the amniotic fluid, or a post-term pregnancy. The condition is

detected most often with electronic fetal heart rate (FHR) monitoring through cardiotocography (CTG), which allows clinicians

to measure changes in the fetal cardiac response to declining oxygen. Specifically, heart rate decelerations detected on CTG

can represent danger to the fetus and to delivery.

Treatment primarily consists of intrauterine resuscitation, the goal of which is to restore oxygenation of the fetus. This can

involve improving the position, hydration, and oxygenation of the mother, as well as amnioinfusion to restore sufficient

amniotic fluid, delaying preterm labor contractions with tocolysis, and correction of fetal acid-base balance.An algorithm is

used to treat/resuscitate babies in need of respiratory support post-birth.

 Causes of fetal distress

The most common cause of fetal distress is the fetus not getting enough oxygen. The fetus gets oxygen from you. You breathe oxygen into
your lungs, then your blood carries it to the placenta. It’s handed off to the placenta and transferred to the fetus's blood. Anything that
interrupts this process may lead to fetal distress.

Other conditions that may lead to non-reassuring fetal status are:

•Too frequent contractions (tachysystole).
•Fetal anemia.
•Abnormal fetal presentation
•Forceps and vacuum extractor misuse
•Placental abruption
•Preeclampsia
•Prolonged and arrested labor
•Umbilical cord problems
•Uterine rupture
 Sign and sypmtoms

Fetal distress is a serious condition that occurs when the baby does not receive enough oxygen or nutrients from the mother's blood. Some
of the signs and symptoms of fetal distress include:
 Decreased fetal movement: The baby's movement is an essential sign of fetal health. Reduced fetal movement or no movement may
indicate fetal distress.
 Abnormal fetal heart rate: The baby's heart rate is a crucial indicator of fetal health. A slow, fast, or irregular heart rate may indicate fetal
distress.
 Meconium-stained amniotic fluid: If the baby is distressed, they may pass meconium, which is the baby's first stool, while still in the
uterus. This can be seen as green or brown fluid during delivery.
 Abnormal levels of hormones in the mother's blood: Certain hormones produced by the fetus can be detected in the mother's blood.
Abnormal levels of these hormones may indicate fetal distress.
 Vaginal bleeding: Vaginal bleeding during pregnancy can be a sign of fetal distress.
 Abnormal maternal blood pressure: High or low blood pressure can be a sign of fetal distress.
 Abnormal ultrasound findings: During routine prenatal ultrasounds, the doctor may detect abnormalities such as structural defects,
growth abnormalities, or signs of chromosomal abnormalities.
It's important to note that these signs and symptoms can also be caused by other factors, and further testing and evaluation are usually
necessary to confirm a diagnosis of fetal distress. If you suspect that there may be something wrong with your developing baby, it's
essential to speak with your healthcare provider right away. They can perform tests and refer you to a specialist if necessary.
 Types of Fetal distress

Fetal distress refers to a condition where the fetus is not getting enough oxygen or is experiencing other forms of stress during pregnancy
or labor. Here are some of the types of fetal distress that may occur:
 Non-reassuring fetal heart rate: This occurs when the fetal heart rate is abnormal and may indicate that the fetus is not getting enough
oxygen.
 Meconium-stained amniotic fluid: Meconium is the first stool of a newborn, and if it is present in the amniotic fluid, it may indicate that
the fetus is in distress.
 Reduced fetal movement: If the fetus is not moving as much as usual, it may be a sign of distress.
 Abnormal fetal breathing movements: The fetus normally practices breathing in the amniotic fluid, and if these movements are
abnormal or absent, it may indicate distress.
 Abnormal fetal position: If the fetus is in an abnormal position, it may cause compression of the umbilical cord, leading to fetal distress.
 Poor placental function: The placenta is responsible for providing oxygen and nutrients to the fetus, and if it is not functioning properly,
it may lead to fetal distress.

If fetal distress is suspected, it is important to seek medical attention immediately. Fetal distress can lead to serious complications for both
the mother and baby, including brain damage or stillbirth.
 Risk factors of fetal distress

Risk factors for fetal distress/non-reassuring fetal status

include anemia, restriction of fetal growth, maternal hypertension or cardiovascular
disease, low amniotic fluid or meconium in the amniotic fluid, or a post-term
pregnancy..

How do you monitor fetal distress?

The two most common ways to monitor fetal heart rate for fetal distress are:

•Electronic fetal heart rate monitor. You wear a device with an attached sensor around your belly continuously
during labor and birth. It sends the sounds of the fetal heart to a computer that your healthcare team can
read.

•Doppler devise. Your obstetrician places a hand-held device on your belly that detects the fetal heartbeat
using sound waves. Your obstetrician uses a Doppler throughout your pregnancy, most likely at your routine
prenatal checkups.
 Management of fetal distress

If you’re in labor, some of the things your obstetrician may do to help during fetal distress include:

 Changing your position. This may increase the blood return to your heart and oxygen supply to the fetus.

 Giving you oxygen through a mask.

 Giving fluids through your IV line.

 Giving you medicine to slow or stop contractions.

 Amnioinfusion (a procedure that places fluid in your amniotic sac to relieve umbilical cord compression).

If your baby is in trouble, your provider may need to deliver it right away. They may use forceps or a vacuum extractor if
you're fully dilated and the baby is low enough in your uterus. Otherwise, they may need to perform an emergency c-section.
Your provider will talk you through what is happening and why they are concerned. They will ask for your consent before any
procedure.
 Prevention of fetal distress

Preventing fetal distress is essential to ensure the healthy development of the baby. Here are some steps that can be taken to reduce
the risk of fetal distress:
 Attend regular prenatal check-ups: Regular prenatal check-ups with a healthcare provider can help detect any potential problems
early on and ensure that the pregnancy is progressing normally.
 Monitor maternal health: It's essential to manage any pre-existing health conditions, such as diabetes or high blood pressure, and
maintain a healthy diet and exercise routine to reduce the risk of complications that could affect the baby.
 Avoid smoking, alcohol, and drugs: Smoking, drinking alcohol, and using drugs during pregnancy can all increase the risk of fetal
distress.
 Manage stress: High levels of stress can increase the risk of complications during pregnancy. Practicing relaxation techniques, such
as yoga or meditation, may help reduce stress levels.
 Monitor fetal movement: Pay attention to the baby's movements and report any changes to the healthcare provider.
 Prompt treatment of infections: Infections during pregnancy can increase the risk of fetal distress. Prompt diagnosis and treatment
of infections can help reduce the risk.
 Properly manage labor and delivery: Proper management of labor and delivery can help reduce the risk of fetal distress. This
includes appropriate pain management, monitoring of the baby's heart rate, and prompt delivery if necessary.
It's important to remember that not all cases of fetal distress can be prevented, and prompt diagnosis and appropriate medical
intervention are essential to ensure the best possible outcome for both the mother and the baby. If you are concerned about fetal
distress, it's important to speak with your healthcare provider right away.
 Complications of fetal distress

Fetal distress is a serious condition that occurs when the fetus does not receive enough oxygen or nutrients from the mother's
blood. This can lead to a range of complications, including:
 Brain damage: The brain is particularly vulnerable to oxygen deprivation. Prolonged fetal distress can lead to brain damage,
which can cause lifelong disabilities, including cerebral palsy, learning difficulties, and developmental delays.
 Organ damage: The organs, including the heart, liver, and kidneys, can also be damaged if the fetus does not receive enough
oxygen and nutrients.
 Fetal death: In severe cases of fetal distress, the fetus may not survive.
 Meconium aspiration syndrome: If the fetus is distressed, they may pass meconium, which is the baby's first stool, while still
in the uterus. This can cause meconium aspiration syndrome, where the baby inhales the meconium, leading to breathing
difficulties and lung damage.
 Preterm birth: Fetal distress can cause the baby to be born prematurely, which can lead to a range of complications,
including respiratory distress syndrome, infections, and developmental delays.
 Low Apgar scores: Apgar scores are used to assess the newborn's overall health immediately after birth. If the baby
experiences fetal distress, they may have a low Apgar score, indicating that they require immediate medical attention.
 It's important to note that not all cases of fetal distress will result in these complications. Prompt diagnosis and appropriate
medical intervention can often help prevent or minimize the risk of complications. If you are concerned about fetal distress,
it's important to speak with your healthcare provider right away.