Question 1

What Is Fetal Distress?

Accepted Answer

Fetal distress, also called “nonreassuring fetal status,” is the term medical professionals use to describe when a fetus is not receiving adequate oxygen during pregnancy or labor (1). Fetal distress is an indication that the baby may not be doing well in utero. When a baby is in distress they may require immediate intervention, such as delivery by C-section or certain methods of intrauterine resuscitation. If fetal distress goes unmanaged it can lead to more severe injuries such as hypoxic-ischemic encephalopathy (HIE).

Question 2

Is There a Difference Between Fetal Distress and Birth Asphyxia?

Accepted Answer

According to an American College of Obstetricians and Gynecologists (ACOG) Committee Opinion in 2005, the term fetal distress was deemed too confusing, as it was very similar to “birth asphyxia” (2). However, many doctors still use the phrase. Birth asphyxia means that the baby is not receiving adequate oxygen during labor or delivery because of an issue like cord compression, placental abruption, or another birth complication. In fetal distress, the baby appears to be lacking adequate oxygen based on fetal heart rate, though the cause may not be known. Instead, the term “nonreassuring fetal status” has been more commonly used to describe the clinician or doctor’s interpretation of the data related to fetal status.

Question 3

What are Some Causes of Fetal Distress?

Accepted Answer

Some common causes of fetal distress include (1):
Anemia
Intrauterine growth restriction (IUGR)
Post-term pregnancy (pregnancy at 42 weeks or more)
Meconium-stained amniotic fluid 
Oligohydramnios (low amniotic fluid)
Pregnancy-induced hypertension
Maternal obesity
Gestational diabetes
Macrosomia (large baby)

Question 4

How Is Fetal Distress Diagnosed?

Accepted Answer

Fetal distress is diagnosed based on fetal heart rate monitoring. The fetal heart monitor is that only tool available to tell whether a baby is getting enough oxygen.  The fetal heart rate should be monitored throughout pregnancy and taken at every prenatal appointment. At times in the pregnancy, such as during labor and delivery, the fetal heart rate is monitored continuously.  Doctors can use internal or external tools to measure the fetal heart rate (1). It is most commonly measured via electronic fetal monitor. The fetal heart rate should be between 110 and 160 beats per minute during the third trimester of pregnancy and labor with moderate variability and fetal accelerations.  This usually inidicates that a baby is well oxygenated.. 
Heart rate abnormalities that are signs of fetal distress:
Tachycardia (an abnormally fast heart rate)
Bradycardia (an abnormally slow heart rate)
Variable decelerations (abrupt decreases in heart rate)
Late decelerations (late returns to the baseline heart rate after a contraction)
All of these circumstances need to be monitored closely by your doctor (1).  They also may indicate that a baby is not getting enough oxygen.

Question 5

What Conditions Are Linked with Fetal Distress?

Accepted Answer

Fetal heart rate monitoring is the way that doctors diagnose fetal distress and whether a baby is getting enough oxygen. Other common pregnancy concerns, however, can also signify that the fetus is in trouble. These include:
Decreased fetal movement: Fetal movement is an important sign that a baby is in good health (3,4). A baby’s movements usually become established around 28 weeks into the pregnancy; during this time there is both movement and stillness, as babies sleep and rest in the womb. During prenatal appointments, medical professionals should ask an expectant mother if her baby’s movements have stopped, slowed, or decreased, since changes in fetal movement can be a sign of fetal distress. If fetal movement is decreased the physician should perform prenatal tests such as non-stress tests (NST), biophysical profiles (BPP), and/or ultrasounds to observe the baby in the womb. 
Cramping: As a baby grows and the uterus expands, mothers will often experience cramping. Doctors should advise mothers to report cramping as soon as it occurs, especially if cramping is severe and if back pain is also present. Intense cramping may be an indication of a serious complication – such as placental abruption – that may cause fetal distress (5). 
Vaginal bleeding: Certain conditions such as placenta previa, vasa previa, and placental abruption can cause bleeding during pregnancy (6). Depending on the severity of these issues, they may all cause fetal distress. Due to this, medical professionals should pay attention to maternal reports of vaginal bleeding as it may be an indication of a more serious condition that could lead to fetal distress. 
Maternal weight gain: It is important for mothers and their physicians to pay attention to how much weight gain occurs during pregnancy. Experts state weight gain between 25 and 40 pounds during pregnancy is normal (7). Pregnancy weight gain outside of this range might lead to fetal distress.
Abnormal results of biophysical profile (BPP): The BPP is measured via ultrasound. The ultrasound technician will collect four measurements: fetal breathing, amniotic fluid volume, fetal movement, and fetal tone (8). Each measurement is given a score of 0 or 2, and a composite score of less than 4  or less reveals fetal compromise.  
Abnormal amniotic fluid levels: Amniotic fluid is one of the main indicators of fetal health (9). Amniotic fluid volume (AFV) can measure too low (oligohydramnios), or too high (polyhydramnios). These abnormalities can be signs of congenital abnormalities, uteroplacental insufficiency, fetal chromosomal abnormalities, cord compression, and others. Where amniotic fluid is low, the umbilical cord which provides oxygen to the baby, can become compressed.  When this happens, the baby may not get enough oxygen.

Question 6

How Is Fetal Distress Treated?

Accepted Answer

Medical personnel must closely monitor all pregnancies, especially high-risk pregnancies, and continuously assess the health of the mother and baby. When physicians recognize or are alerted to signs of fetal distress, they can monitor the baby and decide how to proceed in the safest way. Usually the doctor will do this using fetal heart rate (FHR) monitoring. FHR allows the doctor to monitor signs of hypoxia, the response of the fetus to hypoxia, and the mother’s contractions (1). Once a baby experiences signs of fetal distress on monitoring, the main goal is to return the baby to an oxygen-rich state as soon as possible to avoid the risk of injury. thypically,Sometimes, the best way to alleviate fetal distress is to deliver, thereby removing the baby from an oxygen-deprived environment. Emergnecy CC-section delivery may be the safest and fastest way for this to occur.

Question 7

Can Fetal Distress Cause HIE?

Accepted Answer

Fetal distress occurs when the baby is not well in the womb. Oftentimes fetal distress occurs when a baby is cut off from its oxygen supply, leading to oxygen deprivation. Medical professionals must address the signs of fetal distress immediately in order to prevent the occurrence of hypoxic-ischemic encephalopathy (HIE). If fetal distress is left unmanaged and goes on too long, and HIE will occuroccurs, This canit can lead to long-term, permanent brain damage in the baby. In addition, HIE is associated with an increased risk of other long-term health issues including:
Cerebral palsy
Epilepsy and seizure disorders
Intellectual and developmental disabilities (I/DD)
Behavioral and emotional disorders
Hearing and visual impairments

Signs of Fetal Distress

What is fetal distress?

Terminology

Causes of fetal distress