Fetal Distress

Foetal Distress is not a complication but a symptom of an underlying complication.

Causes of Fetal Distress:

Prolonged Labour: Prolonged Labor can cause fetal distress by putting excess stress on the fetus or by causing decreased blood supply to the placenta.
Causes of prolonged labour like CPD, breech presentation, or failure of the cervix to dilate properly can all cause fetal distress.
Placental Insufficiency: Decreased blood flow through the placenta can be secondary to prolonged labor or due to conditions like hypertension (high blood pressure), diabetes, thyroid problems, infections etc.
Fetal problems: Certain problems that affect the fetus may also cause fetal distress. A small for date fetus or a fetus with heart problems, kidney problems or other congenital defects are more likely to develop fetal distress.
Placental problems: Developmental defects in the placenta can also lead to fetal distress in labor.

Signs of Fetal Distress

The fetus may show signs of distress at any time in the first stage or the second stage of labour. The signs of fetal distress are:

Passage of meconium (foetal stool) in the liquor amnii.
Increase of foetal heart rate above 160 per minute.
Deceased oxygen saturation in the foetal blood as diagnosed by fetal scalp blood sampling.
Decrease of foetal heart rate below 100 per minute.

Management / Treatment of Fetal Distress

Management of a women with fetal distress depends on what stage the distress is discovered.

Fetal Distress in the First Stage of labor: If fetal distress is diagnosed in early first stage , there is no other option but an operative delivery. Cesarian section has to be done as early as possible.
If fetal distress is diagnosed in late first stage with the cervix almost fully dilated and the head well descended in the vagina, forceps delivery or vacuum aspiration may be possible in very expert hands. But if the head is not well descended, and the doctor or midwife not very experienced, a cesarian section is safer.
Fetal Distress in Second Stage of labor: If fetal distress is diagnosed in the second stage of labour, forceps delivery or vacuum aspiration is the first option to be considered.
This is due to the fact that by this time the head has usually descended deep into the vagina and delivery through an abdominal incision will be riskier than a vaginal delivery. The labor needs to be accelerated with medicines like syntocinon or drotaverine and the baby delivered as early as possible.

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