Fetal Distress

Fetal distress, also known as “non-reassuring fetal heart tracing”, is a condition wherein the fetus’ heartbeat decelerates or becomes flat either during pregnancy or during labor which is a sign that there is lack of oxygen to the baby’s brain.

The three types of heart decelerations among fetuses are early, variable and late. Early deceleration, the most common among the three, is usually a sign of head compression; variable, which usually happens during the pushing stage of labor, most often indicates umbilical cord compression while late is the most worrisome of the three because persistent late decelerations among fetuses can indicate that the fetus is not well.

Among the many causes of fetal distress are:

• 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

Mothers with history of stillbirth, intrauterine growth retardation, oligohydramnios or polyhydramnios, multiple pregnancy, rhesus sensitization, hypertension, diabetes and other chronic diseases, decreased fetal movements and post-term pregnancy are the ones whose fetuses may be at risk for fetal distress.

Fetal Distress during Pregnancy

During pregnancy, it may not be easy to detect fetal distress. The best way to tell this is to be alert to any changes in a baby’s movement as the mother’s due date nears. It is normal for a baby’s movements to slow down especially as the due date approaches because the baby has less room to move around within the uterus. However, any stark changes such as not feeling the baby having moved at all must immediately be reported to a midwife or a medical practitioner so some tests can be done to check the health of the baby.

One of the things that a mother may be asked to do is the “kick count”. The mother is asked to count the baby’s movement after breakfast until mid-afternoon, if the movements have not reached 10, she must immediately inform her medical practitioner. If this is the case, the mother will be asked to undergo a non-stress test. If the result is not satisfactory, further tests may be performed such as an ultrasound. If the results are still not reassuring, it may be necessary to deliver the baby immediately.

Fetal Distress during Labor

During labor, one of the ways to tell that a baby is in distress is when meconium or a baby’s stool is detected in the amniotic fluid when the mother’s water breaks.

Or, a baby’s heart rate will be constantly monitored either intermittently or continuously. In intermittent monitoring, a medical practitioner will monitor the baby's movement every 15 minutes with a hand-held Doppler ultrasound called a Sonicaid or an ear trumpet called a Pinard stethoscope during the first stage of labor and five minutes during the pushing stage or after every contraction.

Continuous monitoring would mean having the mother attached to an electronic fetal monitor which is equipped with two sensors to be placed on the mother’s stomach. One sensor will monitor the contractions while the other will monitor the baby’s heartbeat.

If the baby is found to be in distress, medical practitioners may give the mother extra oxygen through a face mask, increase her fluid levels via a drip, let the mother lie down on her left side or temporarily stop any medication she has been given to increase her contractions.

If the baby’s condition does not improve, the medical practitioner may decide to have the baby delivered as soon as possible either via vaginal birth if possible or in most cases via a caesarian section.