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Signs of fetal compromise


Signs of Fetal Distress: What is Fetal Distress?

Understanding Complications Related to Fetal Distress

Fetal distress happens when a baby is not receiving an adequate amount of oxygen during pregnancy or labor. Typically, fetal distress can be detected through an abnormal fetal heart rate. While most pregnancies and childbirth happen without complications, it’s still critical for doctors and other medical providers to monitor the baby throughout every pregnancy stage to ensure that any potential complications are addressed immediately.

When fetal distress goes undetected, many problems can arise during pregnancy and labor. Here’s what you need to know.

What is Fetal Distress?

Fetal Distress is a medical condition which generally refers to “hypoxia” or low levels of oxygen in an unborn child. While it may occur before the onset of labor, it is more common during the delivery process. If fetal distress is not promptly corrected it can lead to injury to the unborn child, or worse.

Signs of Fetal Distress

Some common signs and symptoms of fetal distress include:

  • Abnormal Heart Rates
  • Decrease in Fetal Movement
  • Maternal Cramping
  • Abnormal Maternal Weight Gain
  • Vaginal Bleeding
  • Meconium in Amniotic Fluid

Each of these signs or symptoms may indicate fetal distress and should be monitored closely.

Abnormal Heart Rates

Babies who are progressing well in utero will have stable and robust heartbeats. Changes in heart rates and slower movement patterns or no movement at all can indicate a fetus may be in fetal distress. According to the National Center for Biotechnology Information (NCBI), a healthy fetal heart rate should be between 110 and 160 beats per minute (bpm). The following are heart rate abnormalities that can be associated with fetal distress:

  • Fetal tachycardia is an abnormally fast heart rate and is identified by a heart rate higher than 160 to 180 bpm.
  • Fetal bradycardia is an abnormally slow heart rate and is identified by a heart rate of less than 110 bpm.
  • Variable decelerations happen when there is a sudden decrease in the fetal heart rate, and the decline is greater than or equal to 15 beats per minute and lasts for longer than 15 seconds — but less than 2 minutes from the onset to the return of the baseline rate.
  • Late decelerations in a fetal heartbeat can happen through excessive uterine contractions or maternal hypotension, resulting in a decreased blood flow to the placenta. This is a cause for concern, and it can point to fetal acidemia. Fetal acidemia occurs when the blood becomes abnormally acidic.
Decrease in Fetal Movement

Medical professionals will monitor fetal movement to confirm a baby is progressing healthfully. Around 28 weeks of gestation, a baby will begin to establish movement patterns, including rest and stillness in the womb. Doctors should ask expectant mothers if there are any noticeable changes in movement or movements that have stopped or decreased. Any decrease or abnormal change in movements can be a sign of fetal distress.

Maternal Cramping

It’s common for mothers to experience cramping as the fetus grows and the uterus expands. However, if intense cramping, along with severe back pain is happening, it could point to fetal distress and other complications. Report cramping to your doctor as soon as you begin feeling them so that they can be monitored.

Maternal Weight Gain

Healthy weight gain for expectant mothers should be between 25 and 40 pounds. It’s crucial for doctors and mothers to monitor weight gain, as excessive weight gain over 40 pounds could lead to fetal distress.

Vaginal Bleeding

When a pregnant mother is experiencing vaginal bleeding, it should be reported to medical professionals immediately. Vaginal bleeding could indicate the following problems related to fetal distress:

Placenta previa occurs when the placenta partially or completely covers the mother’s cervix (the lower part of the uterus). Placenta previa can cause heavy bleeding during pregnancy and delivery.

Vasa previa occurs when some of the fetal umbilical cord blood vessels run across or close to the cervix’s internal opening. Since the vessels are inside the amniotic membranes, they are unprotected by the umbilical cord or placenta, and as a result, the vessels can rupture as the membranes break. Although vasa previa is very rare, it can cause severe pregnancy complications.

Meconium in the Amniotic Fluid

Meconium, a thick, tar-like substance, can be found in a baby’s intestines during pregnancy. While it’s not usually released from your baby’s bowel until after birth, in some cases, a baby will have a bowel movement before birth, releasing the meconium into the amniotic fluid. If meconium is present, it could indicate fetal distress, and your doctors should look for additional signs of fetal distress.

Dangerous (too low or too high) amniotic fluid levels can also point to fetal distress and should be monitored regularly.

Common Causes of Fetal Distress

While Fetal Distress is thankfully not a common occurrence, there are a number of reasons it can occur.

Mispositioning

The term mispositioning generally refers to when the unborn child is in a less than optimal delivery position which makes it difficult and sometimes even dangerous in the labor process. The baby being in the wrong position can occur naturally but it is important to correct the position to avoid complications such as fetal distress.

Improper Medical Tool Use

Although medical tools (i.e. forceps, vacuum extractors) may be of important use during the delivery, if used incorrectly they can lead to a whole host of complications, including but not limited to, fetal distress.

Tangled Umbilical Cord

Before the baby gets delivered, the umbilical cord can become wrapped around the unborn child’s neck or other body parts. If the tangle is not resolved and tightens it can lead to fetal distress, bodily injury or worse.

Poor Blood Circulation

Blood circulation is critical to the unborn child as that is the primary way they receive oxygen while inside their mother. There can be a number of causes for poor blood circulation such as health conditions of the mother (ie high blood pressure, asthma, diabetes) or it results from the stress of the pregnancy and labor itself on the mother’s body.

Placental Abruption

The placenta provides the unborn child with vital nutrients they need during their development. If the placenta ruptures or becomes detached from the wall of the uterus, fetal distress quickly occurs. This can be an extremely serious event should it occur. While acute trauma and the birth of a twin that results in fluid loss are recognized as possible causes of placenta abruption, in most instances the exact cause is not known.

Uterine Rupture

In this dangerous situation, if the uterus ruptures, severe internal bleeding can result. This complication requires immediate attention as both the mother and child’s life can potentially be in jeopardy.

Mismanaging Fetal Distress Resulting in Birth Injury

Fetal distress is a complication that requires detection and proper intervention to prevent injury to the unborn child. If you believe that your child or loved one suffered an injury as a result of a medical provider failing to follow the standard of care during a fetal distress event, you may have a case for medical malpractice. Speak to one of our team of experienced birth injury attorneys to discuss your unique situation today.

The Long-Term Consequences of Fetal Distress

When a baby is delivered under fetal distress conditions, the consequences can be devastating, and the complications can pose life-long medical challenges. Some common conditions that can be linked to fetal distress are:

  • Cerebral palsy
  • Brain injuries
  • Motor impairment
  • Hearing and visual impairment
  • Seizure disorders
  • Mental health disabilities

While it can be challenging to detect disabilities in newborns, some symptoms may be present immediately, such as breathing difficulties and seizures as well as:

  • Eating/feeding complications
  • Failure to meet milestones such as sitting up and talking
  • Lack of muscle tone or “floppy” arms and legs.
  • Muscle spasms
  • Lack of attentiveness/alertness
  • Showing preference to one side of the body

If you notice any of the signs above, talk to your pediatrician as soon as possible for a proper diagnosis.

Did Your Child Suffer a Birth Injury Due to Fetal Distress? We can Help

If your child suffered a birth injury due to improper monitoring of fetal distress, our Philadelphia birth injury attorneys at The Villari Firm, PLLC are here to help you seek justice. Our experienced attorneys work with leading experts, including doctors and other legal professionals, to investigate and prepare cases for our clients. We spare no expense to ensure we are armed with everything needed to help our clients receive the compensation they deserve.

Contact The Villari Firm, PLLC at (215) 372-8889 to schedule a free consultation today.

Fetal distress | Pregnancy Birth and Baby

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Key facts

  • Fetal distress is a sign that your baby is not well.
  • Your doctor or midwife will monitor your baby’s heartbeat during pregnancy and labour to assess their wellbeing.
  • If your baby shows signs of fetal distress, your midwife or doctor will act quickly to try and treat any underlying cause.
  • You may need help to birth your baby quickly with an assisted (instrumental) delivery or caesarean section.
  • Fetal distress can increase the risk of birth complications, especially if it isn’t treated quickly.

If you are pregnant and notice a decrease in your baby’s movements, seek urgent medical attention. This may be a sign that your baby is unwell.

What is fetal distress?

Fetal distress is a sign that your baby is not well. It happens when the baby isn’t receiving enough oxygen through the placenta.

Fetal distress can sometimes happen during pregnancy, but it’s more common during labour.

What causes fetal distress?

Fetal distress may occur when the baby doesn’t receive enough oxygen because of problems with the placenta (such as placental abruption or placental insufficiency) or problems with the umbilical cord (such as cord prolapse).

It is more common if you are overdue, have pregnancy complications or when there are other complications during labour. Sometimes it happens because the contractions are too strong or too close together.

Your baby is more likely to experience fetal distress if:

  • you are obese
  • you have high blood pressure in pregnancy or pre-eclampsia
  • you have a chronic disease, such as diabetes, kidney disease or cholestasis(a condition that affects the liver in pregnancy)
  • you have a multiple pregnancy
  • your baby has fetal growth restriction

How is fetal distress diagnosed?

Fetal distress is diagnosed by monitoring the baby’s heart rate. A slow heart rate, or unusual patterns in the heart rate, may signal fetal distress.

Your doctor or midwife might pick up signs of fetal distress as they listen to your baby’s heart during pregnancy.

Your baby’s movements are a sign that your baby is well. A change in your baby’s movements may be a sign of fetal distress.

If you haven’t felt your baby move, or the pattern of moments has changed, contact your doctor or midwife immediately, as this may be a sign of fetal distress.

Another sign of possible fetal distress is meconium in the amniotic fluid. Let your doctor or midwife know right away if your notice your amniotic fluid is green or brown, since this could signal the presence of meconium (newborn poo, that your baby may pass while still in your uterus if they are distressed).

How is fetal distress managed?

There are a few ways that fetal distress may be managed. Your doctor will assess your situation and discuss with you the best management option in your situation.

If you are not in labour

Depending on your situation, your doctor or midwife may recommend interventions such as medicines or intravenous fluids. If these interventions do not help, your doctor may recommend an emergency caesarean section so you birth your baby quickly.

If you are in labour

You will usually be given you oxygen and fluids. Sometimes changing position, such as turning onto your side, can reduce the baby’s distress.

You may be given medicine to slow down the contractions. If you had medicines to speed up labour, these may be stopped if there are signs of fetal distress.

Sometimes, a baby in fetal distress needs to be born quickly. Your doctor may recommend an assisted (or instrumental) birth or you might need to have an emergency caesarean.

Most of the time, there will be time to discuss your options with your doctor and/or midwife. However, in some emergency situations, your doctor or midwife will need to act quickly. If there are any medical interventions you object to, such as receiving a blood donation, it’s a good idea to make sure that your doctor and/or midwife are aware of this when you arrive at the hospital.

Does fetal distress have any lasting effects?

Babies who experience fetal distress are at greater risk of complications after birth. Prolonged lack of oxygen during pregnancy and birth can lead to serious complications for the baby, if it is not noticed and managed early. Complications may include brain injury, cerebral palsy and even stillbirth.

Fetal distress may require an assisted birth or caesarean section. While these interventions are safe, they are associated with their own set of risks and complications. Having fetal distress in one pregnancy doesn’t mean you will necessarily experience fetal distress in your next pregnancy. Every pregnancy is different. If you’re worried about future pregnancies, it can help to talk to your doctor or midwife so they can explain what happened before and during the birth.

Where can I find resources and support?

If your labour didn’t go to plan, you may experience difficult feelings about their birth experience.

If you feel sad, disappointed or traumatised about what happened, it is important to talk to someone. There are lots of people and organisations who can help, including:

  • your doctor
  • PANDAon 1300 726 306
  • Australasian Birth Trauma Association
  • Beyond Blueon 1300 22 4636

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:
Australasian Birth Trauma Association (What is birth trauma?), King Edward Memorial Hospital (Fetal compromise (acute): Management if suspected), Royal Australian and New Zealand College of Obstetricians and Gynaecologists (Labour and birth), Royal Australian and New Zealand College of Obstetricians and Gynaecologists (Intrapartum fetal Surveillance Clinical Guideline)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2022


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Related pages

  • Baby movements during pregnancy
  • Fetal heart rate monitoring
  • Giving birth - stages of labour
  • Induced labour
  • Interventions during labour
  • Labour complications

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Fetal heart rate monitoring

During pregnancy and labour, your baby's heart rate is monitored to check for any signs of distress.