GROUP 7

1.BERINE BUNDI HSN211-0007/2021

2. PURITY LIRUGA HSN211-0019/2021
3.MARY KURIA HSN211-0068/2021
4.MARGARET WANGARI HSN211-0070/2021
5.JOY MUSENYA HSN211-0007/2021
 FETAL DISTRESS

-It is a non reassuring fetal status

-Refers to the signs before and during child birthing indicating that the foetus is not well.
Involves the lack of fetal reverse of presence of hypoxia ,acidosis or asphyxia.
Occurs when the foetus has not been receiving enough oxygen.
 TYPES OF FETAL DISTRESS

 Acute fetal distress – occurs suddenly due to acute events

 Chronic fetal distress – occurs slowly usually due to chronic
placental insufficiency and fetal growth retardation.
 RISK FACTORS

 Anaemia
 Hypertension
 Diabetes
 Maternal infections
 Asthma
 Post term pregnancies
 Labour induction
 Lying in supine position
 Fetal anaemia
 Prematurity
 CAUSES

 Hypertonic uterine action

 Cord compression
 Cord prolapse
 Placenta abruption
 Vasa previa
 Uterine rapture
 Overactivity of the uterus due to uterotonics eg oxytocin
 Certain drugs eg narcotic and non narcotic analgesics
PATHOPHYSIOLOGY

In a normal fetus with adequate oxygenation ,glycolysis and citric acid cycle are
predominant.
In case of chronic placental insufficiency and intrauterine hypoxia:
 Formation and deposition of lactic acid and pyruvic acid occurs through anaerobic
glycolysis cause myocardial hypoxia, respiratory acidosis and metabolic acidosis.
 Fetal tachycardia and bradycardia occur due to initial stimulation and later depression of
the cardiac pacemaker.
 Fetus may pass meconium , due to vagal stimulation which enhances increased intestinal
activity and causes opening of the anal sphincter.
 Total sudden cessation of oxygenation will affect the pontine region and cause sudden fetal
death.
 CLINICAL PRESENTATION

 Abnormal fetal heart rate ;tachycardia or bradycardia

 Low amniotic fluid levels
 Meconium staining of the liquor
 Cramping
 Vaginal bleeding
 DIAGNOSIS

 Physical exam
 Health history
 Cardiotocography –
 Ultrasonography –biophysical profile
 Amnioscopy
 Hormonal studies
 Daily fetal movement count
 Contraction stress test
NURSING MANAGMENT

`Fetal assessment
FHR baseline ,variability ,the presence of periodic or non-periodic
acceration and decellerations, depth, duration
`maternal assessment
Positioning, infection, uterine activity, blood pressure, medication
Psychosocial elements; anxiety, pain, lack of knowledge
MANAGEMENT CT…

 Turn the woman on her side or a modified knee chest position to relieve
pressure on the umbilical cord.
 Administer oxygen(6-8 l/min) to improve the maternal-fetal oxygenation
 Increase IV infusions to correct dehydration or dilute oxytocin stimulatory
effects
 Monitor amnioinfusion, an invasive procedure that involves the instilling
warm fluid into the uterine cavity by infusion pump to increase fluid
volume and relieve pressure on the umbilical cord.
 Correct hypertension if present by infusion of crystalloids eg NS,RL

COMPLICATIONS

 Brain injury
 Cerebral palsy
 Still birth
REFERENCES

 Midwifery nursing