Fetal Distress I.

Brief Discussion

Compromise of the fetus during the antepartum period (before labor) or intrapartum period (birth process). The term "fetal distress" is commonly used to describe fetal hypoxia (low oxygen levels in the fetus). The concern with fetal hypoxia is it may result in fetal damage or death if not reversed or if the fetus is not promptly delivered. Fetal distress can be detected due to abnormal slowing of labor, the presence of meconium (dark green fecal material from the fetus) or other abnormal substances in the amniotic fluid, or via fetal monitoring with an electronic device showing a fetal scalp pH of less than 7.2.
Fetal distress, also more commonly known as nonreassuring fetal heart tracing, is basically a particular complication when during labor your babys heart beat becomes flat, or drops to a lower level repeatedly causing stress for your baby. When you are in labor your babys heart rate will constantly be monitored for any sign of complications or stress. There are three types of heart decelerations: Early - These are usually indicative of a head compression and are the most common of all three. Variable - These are usually indicative of a cord compression and are usually seen in the pushing stage of labor. Late - These are the ones which usually cause the most concern. A single deceleration may not be so bad, but persistent late decelerations are usually followed by concern for the babys well being. II. III. IV. V. VI. VII. VIII. IX. X. XI. Risk Factors Breathing problems Abnormal position and presentation of the fetus Multiple births Shoulder dystocia Umbilical cord prolapse Nuchal cord Placental abruption Premature closure of the fetal ductus arteriosus Uterine rupture

While some change in fetal heart pattern during labor is fairly normal, there are also a variety of different factors which may cause fetal distress. Some of the common causes include: A loop of umbilical cord around the baby's neck. Almost 30% of babies have a cord around their neck Uterine infection Placental abruption Uterine rupture

XII.

Signs and symptoms

Reduced fetal activity Meconium in amniotic fluid Increased fetal heart rate Decreased fetal heart rate Increased variability of fetal heart rate Fetal acidosis Increased fetal blood lactate level Fetal lactic acidosis Diagnostic procedures

XIII.

Medical management Instead of referring to "fetal distress" current recommendations hold to look for more specific signs [2] and symptoms, assess them, and take the appropriate steps to remedy the situation. Traditionally the diagnosis of "fetal distress" led the obstetrician to recommend rapid delivery by instrumental delivery or by caesarean section if vaginal delivery is not advised Pharmacologic drugs Nursing management

XIV. XV.