FETAL DISTRESS

In medicine (obstetrics) it refers to the presence of signs in a pregnant woman

before or during childbirth that suggest the fetus may not be well.

SIGNS AND SYMPTOMS

Decreased movement felt by the mother

Meconium in the amniotic fluid
Non-reassuring patterns seen in cardiotocography(is a technical means of
recording(-graphy) the fetal heartbeat (cardio-) and the uterine contractions(toco-) during pregnancy, typically in the 3 rd trimester.
*increased or decreased fetal heart rate (tachycardia and bradycardia)
especially during and after contraction
*decreased variability in the fetal heart rate
Biochemical signs, assessed by collecting a small sample of babys blood
from a scalp prick through the open cervix in labor
*fetal metabolic acidosis (is a condition that occurs when the body produces
excessive quantities of acid or when kidneys are not removing enough acid
from the body)
*elevated fetal blood lactate levels (from fetal scalp blood testing) indicating
the baby has a lactic acidosis (is a physiological condition characterized by
low pH in body tissues and blood (acidosis) accompanied by the build up of
lactate, esp. L-lactate and is considered a distinct form of metabolic
acidosis.,the condition typically occurs when cells retrieve too little oxygen
(hypoxia) for example, during vigorous exercise. In this situation, impaired
cellular respiration leads to lower pH levels. Simultaneously, cells are forced
to metabolize glucose anaerobically, which leads to lactate formation.
Therefore, elevated lactate is indicative of tissue hypoxia, hypoperfusion, and
possible damage.)

Some of these signs are more reliable predictors of fetal compromise than others.
For example, cardiotocography can give high false positive rates, even when
interpreted by highly experienced medical personnel. Metabolic acidosis ia a more
reliable predictor, but is not always available.

CAUSES
There are many causes of fetal distress including:

Breathing problems
Abnormal position and presentation of the fetus
Multiple births
Shoulder dystocia
Umbilical cord prolapse
Nuchal cord ( a loop of umbilical cord around the fetal neck)
Placental abruption
Premature closure of the fetal ductus arteriosus (is a blood vessel connecting
the pulmonary artery to the proximal descending aorta. It allows most of the
blood from the right ventricle to bypass the fetuss fluid-filled non-functioning
lungs. Upon closure at birth, it becomes the ligament arteiosum. There are
two other shunts, the ductus venosus and the foramen ovale.
Uterine rupture
Intrahepatic cholestasis of pregnancy, a liver disorder during pregnancy
TREATMENT

Instead of referring to fetal distress current recommendations hold to look for

more specific signs 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
caesarian section if vaginal delivery is not advised.
REFERENCES
1. ^Fetal Distress at the US National Library of Medicine Medical Subject
Headings (MeSH)
2. ^a b ACOG. Committee Opinion, Number 326, December
2005:Inappropriate Use of Terms Fetal Distress and Birth Asphyxia
Retrieved June 9,2010.