Sign of Fetal Distress

Inc. Fetal Heart Rate

By: Okky Proud College Student of UPN

Definition
In medicine (obstetrics), fetal distress is the presence of signs in a pregnant woman before or during childbirththat the fetus is not well or is becoming excessively fatigued.

Signs and symptoms

Decreased movement felt by the mother Meconium in the amniotic fluid Cardiotocography signs
increased or decreased fetal heart rate (tachycardia and bradycardia), especially during and after a contraction decreased variability in the fetal heart rate

Biochemical signs, assessed by collecting a small sample of baby's blood from a scalp prick through the open cervix in labour
fetal acidosis elevated fetal blood lactate levels indicating the baby has a lactic acidosis

More Info
Some of these signs are more reliable predictors of actual distress than others. For example, cardiocartography can give high false positive rates, even when interpreted by highly experienced medical personnel. Acidosis is a highly reliable predictor, but is not always available. A highly effective method of assessment of distress would be to use fetal heart rate as a first indicator of distress, to be confirmed with a more reliable method of diagnosis before radical treatment is performed.

Causes
Breathing problems Abnormal position and presentation of the fetus Multiple births Shoulder dystocia Prolapsed umbilical cord Nuchal cord Placental abruption Premature closure of the fetal ductus arteriosus

Risk Factors
Women with a history of:
Stillbirth Intrauterine growth retardation Oligohydramnios or polyhydramnios Multiple pregnancies Rhesus sensitisation Hypertension Diabetes and other chronic diseases Decreased fetal movements Post-term pregnancy.

There is some evidence that maternal age over 35 years is an independent risk factor for uteroplacental insufficiency and fetal distress

Treatment
In many situations fetal distress will lead the obstetrician to recommend steps to urgently deliver the baby. This can be done by induction, or in more urgent cases, a caesarean section may be performed.

Fetal Heart Rate

Normal range at term is 120-160 bpm. Fetal bradychardia (<120bpm) or tachycardia (> 160bpm) may be associated with hypoxia but several other factors can cause tachycardia, e.g. maternal pyrexia or dehydration. Late decelerations, defined as uniform,repeated, periodic slowing of the fetal heart rate, whose onset is from mid to end of the contraction, with its nadir more than 20 seconds after the peak intensity of the contraction, suggest fetal hypoxia.

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