Fetal Distress

What is Fetal Distress?

Fetal distress is a term used to describe a condition where a baby is exhibiting changes in heart rate, movement or showing signs of oxygen deprivation typically just prior to or during labour. Many babies experience short periods of oxygen deprivation during labour, but some babies are not able to tolerate brief  periods of low oxygen or are exposed to long periods without adequate oxygen. In these situations, if delivery is not expedited the babies can suffer from brain damage.

What are the Signs of Fetal Distress?

When a baby in the womb is having difficulty with oxygenation, there will typically be signs and symptoms available to the healthcare providers, including

• Abnormal or atypical heart beat patterns apparent when listening to the heart rate or more commonly seen on continuous fetal monitoring
• Decreased fetal movement can suggest a baby that is not tolerating the womb.
• Meconium-stained amniotic fluid which reflects the passing of fetal stool which is often a response to stress.
• Changes in fetal breathing or tone which can be seen on ultrasound in some cases.

What Causes Fetal Distress?

Fetal distress can reflect a number of problems interfering with adequate oxygenation to the baby including:

• Umbilical cord problems (e.g., compression or prolapse of the umbilical cord)
• Placental insufficiency (e.g., from preeclampsia or post-term pregnancy)
• Maternal complications (e.g., low blood pressure, anemia, infection)
• Uterine rupture or overly strong contractions (e.g., from the use of oxytocin)

What Is the Significance of Fetal Distress?

Fetal distress requires timely recognition and appropriate response which are critical to prevent serious harm. If not promptly addressed, fetal distress can lead to a brain injury, cerebral palsy and even death.

Common Mistakes

Common mistakes made related to fetal distress include:

• Inadequate or interrupted fetal monitoring (e.g., not using continuous monitoring)
• Failure to recognize abnormal fetal heart rate patterns (e.g., ignoring warning signs on the fetal monitor)
• Delays in calling for help or performing an emergency C-section (e.g., waiting too long to act once fetal distress is identified)
• Misuse or overuse of drugs like oxytocin (Pitocin) (e.g., continuing medication despite signs the baby is not tolerating contractions)
• Failure to respond to meconium-stained amniotic fluid (e.g., not preparing for breathing problems at birth)
• Poor communication between doctors, nurses, and other staff (e.g., unclear roles or delays caused by miscommunication)
• Attempting vaginal delivery when an urgent C-section is needed (e.g., using forceps or vacuum inappropriately during distress)