Fetal Distress: Diagnosis, Conditions &

Treatment
Historically, the term fetal distress has been used to describe
when the fetus does not receive adequate amounts of oxygen
during pregnancy or labor. It is oftentimes detected through
an abnormal fetal heart rate. However, while the term fetal
distress is commonly used, it is not well defined. This makes
it more difficult to make an accurate diagnosis and provide
proper treatment. Because of the terms ambiguity, its use
has the potential to lead to improper treatment.
Fetal distress is commonly confused with the term birth
asphyxia. Birth asphyxia occurs when the baby does not have
adequate amounts of oxygen before, during, or after labor.
This may have multiple causes, some of which include low
oxygen levels in the mothers blood or reduced blood flow
due to compression of the umbilical cord.
As many have incorrectly used fetal distress and birth
asphyxia as interchangeable terms, the Committee on
Obstetric Practice of the American Congress of Obstetricians
and Gynecologists (ACOG) has expressed concern regarding
the use of the two terms. ACOG recommends that the term
fetal distress be replaced with non-reassuring fetal status.
Along with this new term, ACOG further recommends
physicians add to the diagnosis a list of additional findings
such as fetal tachycardia, bradycardia, repetitive variable
decelerations, low biophysical profile, and late
decelerations. ACOGs Committee on Obstetric Practice has
also stated that the term birth asphyxia should no longer be
used as it is too vague of a diagnosis for medical use.

Fetal Distress Diagnosis

It is important for physicians to monitor the fetus throughout
pregnancy to detect any potential complications. One of the
more widely used methods of monitoring is electronic fetal
heart rate (FHR) monitoring.
Benefits of FHR 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 mothers contractions
The ability to monitor the response of the fetus to hypoxia
A more positive outcome for high risk deliveries
Nonetheless, FHR monitoring does come with risks as well,
including an increased likelihood of having a cesarean
section due to misinterpretation of FHR monitoring results.

Conditions Behind Fetal Distress

Potential precursors to fetal distress or non-reassuring
fetal status 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 (PIH)
Post-term pregnancies (42 weeks or more)
Intrauterine Growth Retardation (IUGR)
Meconium-stained amniotic fluid (a condition in which
meconium, a babys first stool, is present in the amniotic fluid
which can block fetal airways)

Fetal Distress Treatment

The primary treatment used for non-reassuring fetal status is
intrauterine resuscitation. This will help prevent any
unnecessary procedures.
Some means of intrauterine resuscitation include:
Changing the mothers 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
Nonetheless, there are cases in which an emergency cesarean
section is necessary. However, due to the over-diagnosis of
fetal distress and potential misinterpretation of the fetal heart
rate, it is recommended to confirm a potential fetal distress
diagnosis with a fetal blood acid base study. Overall, this
condition points to the importance of prenatal care and
proper monitoring of the mother and fetus throughout
pregnancy