Fetal distress
Historically, the
term fetal distress has been used to describe when a fetus does not receive
enough oxygen during pregnancy or childbirth. It is often detected by an
abnormal fetal heartbeat. However, although the term fetal distress is widely
used, it is not clearly defined. This makes it difficult to make an accurate
diagnosis and prescribe adequate treatment. Due to the term's ambiguity, its
use can lead to misuse.
Fetal distress is
often confused with the term birth asphyxia. Birth asphyxia occurs when a baby
does not get enough oxygen before, during, or after birth. This can have
several causes, some of which include low oxygen levels in the mother's blood or
reduced blood flow due to compression of the umbilical cord.
Diagnosis of fetal distress
It is important for
doctors to monitor the fetus throughout pregnancy to identify possible
complications. One of the most widely used monitoring methods is electronic
fetal heart rate monitoring.
The benefits of fetal
heart rate monitoring include:
- The ability to recognize the development of hypoxia (when the fetus does not receive adequate amounts of oxygen) by analyzing patterns in the fetal heart rate
- The ability to monitor the mother’s contractions
- The ability to monitor the response of the fetus to hypoxia
- A more positive outcome for high-risk deliveries
However, fetal heart
rate monitoring also comes with risks, including an increased chance of a
caesarean section due to misinterpretation of fetal heart rate monitoring
results.
Conditions underlying fetal distress
Potential warning
signs of fetal distress or fetal distress may include:
- Anemia (the most prevalent obstetric condition seen behind non-reassuring fetal status)
- Oligohydraminos (a condition in which there is a lower level of amniotic fluid around the fetus)
- Pregnancy Induced Hypertension
- Post-term pregnancies (42 weeks or more)
- Intrauterine Growth Retardation
- Meconium-stained amniotic fluid (a condition in which meconium, a baby’s first stool, is present in the amniotic fluid which can block fetal airways)
Meconium-stained
amniotic fluid (a condition in which meconium, the baby's first stool, is
present in the amniotic fluid, which can block the fetus's airways)
Treatment
The main treatment
used in the unsatisfactory condition of the fetus is intrauterine
resuscitation. This will help avoid unnecessary procedures.
Some means of
intrauterine resuscitation include:
- Changing the mother’s position
- Ensuring the mother is well-hydrated
- Ensuring the mother has adequate oxygen
- Amnioinfusion (the insertion of fluid into the amniotic cavity to alleviate compression of the umbilical cord)
- Tocolysis (a therapy used to delay preterm labor by temporarily stopping contractions)
- Intravenous hypertonic dextrose
However, there are times when an emergency caesarean section is necessary. However, because of the overdiagnosis of fetal distress and the possible misinterpretation of fetal heart rate, it is recommended that a potential diagnosis of fetal distress be confirmed by a fetal acid-base blood test. Overall, this condition highlights the importance of prenatal care and proper monitoring of the mother and fetus throughout pregnancy.