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Fetal Distress

By Julie S. Moldenhauer, MD, Associate Professor of Clinical Obstetrics and Gynecology in Surgery, The Garbose Family Special Delivery Unit;Attending Physician, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia;The University of Pennsylvania Perelman School of Medicine

Fetal distress refers to signs before and during childbirth indicating that the fetus is not well.

Fetal distress is an uncommon complication of labor. It typically occurs when the fetus has not been receiving enough oxygen. Fetal distress may occur when the pregnancy lasts too long (postmaturity) or when complications of pregnancy or labor occur.

Usually, doctors identify fetal distress based on an abnormal heart rate pattern in the fetus. Throughout labor, the fetus’s heart rate is monitored. It is usually monitored continuously with electronic fetal heart monitoring. Or, a handheld Doppler ultrasound device may be used to check the heart rate every 15 minutes during early labor and after each contraction during late labor.

If a significant abnormality in the heart rate is detected, it can usually be corrected by the following:

  • Giving the woman oxygen

  • Increasing the amount of fluids given intravenously to the woman

  • Turning the woman on one side or the other

If these measures are not effective, the baby is delivered as quickly as possible by a vacuum extractor, forceps, or cesarean delivery.

Did You Know...

  • An abnormal heart rate in a fetus may be the earliest sign of fetal distress.

Sometimes the amniotic fluid (fluid around the fetus in the uterus) appears green after the membranes have ruptured. This discoloration is caused by the fetus’s first stool (called meconium). Sometimes the baby inhales (aspirates) amniotic fluid containing the meconium before labor or during delivery. If the baby inhales meconium, the baby may have difficulty breathing shortly after birth (called meconium aspiration syndrome).

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