Signs and Symptoms of Fetal Distress

Fetal distress refers to signs before and during childbirth indicating that the fetus is not well. Fetus is the medical term for a baby prior to delivery. Fetal distress is a complication of labor. It occurs when the baby has not been receiving enough oxygen (birth asphyxia).

The baby reacts at the onset of asphyxia with a series of responses, a regulated redistribution of blood flow that serves to limit the effects of oxygen limitation in vital organs. This enables the baby to survive asphyxia intact unless the insult is profound or prolonged. Each of these stresses produces characteristic fetal heart rate patterns: late decelerations, variable decelerations, or prolonged bradycardia.

Common Conditions
The main sign doctors and nurses look for to determine fetal distress is a non-reassuring heart rate on the fetal monitoring strips. There are a number of conditions that can occur during labor and delivery that may lead to the fetal heart rate to become non-reassuring.

• Anemia (most prevalent obstetric condition seen behind non-reassuring fetal status)
• Oligohydramnios (a condition in which there is a lower level of amniotic fluid around the baby)
• Pregnancy Induced Hypertension (PIH)
• Post-term pregnancies (42 weeks or more)
• Intrauterine Growth Restriction (IUGR)
• Meconium-stained amniotic fluid (a condition in which meconium, a baby’s first stool, is present in the amniotic fluid which can block baby’s airways)

Common Signs of Fetal Distress
Decreased Fetal Movement in the Womb
Movement within the womb is an important indicator of the baby’s health. Some regular pauses in movement are normal because babies sleep in the womb. If the baby becomes less active or ceases to move, this may be a cause for concern.

Abnormal Fetal Heart Rate
To observe an unborn baby’s heart rate, labor and delivery nurses and obstetricians can use either an external or internal fetal monitoring device. External monitoring is done through a belt-like device that can be strapped around a mother’s abdomen, while internal monitoring involves attaching an electrode to the baby’s scalp. Internal monitoring provides the most accurate monitoring.

During the actual labor process, the important document the nurses and doctors must watch are fetal monitoring strips (these are the print outs from the monitor). These strips will have some of the earliest and most telling signs of the potential for fetal distress. Nurses and doctors during the labor and delivery process look for certain heart rate patterns that are recognized signs of fetal distress.
Some fetal heart rate patterns are known indicators of fetal distress. These are called non-reassuring heart rate patterns. The following fetal heart rate patterns are examples of nonreassuring patterns and warrant further investigation and medical intervention:

• An abnormally fast heart rate (tachycardia)
• An abnormally slow heart rate (bradycardia)
• Abrupt decreases in heart rate (variable decelerations)
• Late returns to the baseline heart rate after a contraction (late decelerations)

Abnormal Amniotic Fluid Level
The amount of amniotic fluid can be determined using a variety of ultrasound methods, including a qualitative assessment, the single deepest pocket (SDP), and the amniotic fluid index (AFI). The qualitative assessment is fairly subjective. The ultrasonographer scans the uterus and reports whether the amniotic fluid volume appears to be low, normal, or high, based on their own experience.

If there is abnormally low amniotic fluid, this is a condition called oligohydramnios, which can lead to oxygen deprivation and birth injuries like Hypoxic Ischemic Encephalopathy (HIE) and cerebral palsy (CP).

Abnormal Results of Biophysical Profile (BPP)
A baby’s biophysical profile (BPP) is also often taken if the results of a Nonstress Test (NST) are nonreassuring. In addition to the NST results, the BPP includes an ultrasound to assess fetal movement, breathing, tone, and amniotic fluid volume.

Vaginal Bleeding
Vaginal bleeding is common during pregnancy. Bleeding can also be an indication that something is wrong with the pregnancy. One particularly dangerous example is placental abruption, which occurs when the placenta tears away from the womb. This causes the baby to be deprived of oxygen.

A placental abruption and other placental problems that cause bleeding require very close monitoring, and in many cases, the mother should be admitted to the hospital and given an emergency C-section.

Cramping
Cramping is normal during pregnancy. As the baby grows, the uterus needs to expand. In some cases cramping is an indication of something more serious, such as miscarriage, placental abruption, preeclampsia, a urinary tract infection, or preterm labor.

Maternal High Blood Pressure (Preeclampsia)
Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure* and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.

Insufficient or Excessive Maternal Weight Gain
Experts believe that for women with a healthy pre-pregnancy weight, a weight gain of anywhere between 25 and 35 pounds is normal during pregnancy.

Fetal Distress that is not recognized and responded to is negligence and this can cause a birth injury including Cerebral Palsy and other brain injuries to a baby.

Healthcare providers, including both labor/delivery nurses and doctors, must recognize and react to signs of fetal distress. This may include supplemental oxygen, turning the mom and signs of the distress that do not improve or indicate profound fetal distress they must deliver the baby quickly including performing a Cesarean Section (c-section).

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If your child suffered a serious birth injury or lifetime disability due to a mistake before, during or after delivery, a lawsuit may be the best way to find out once and for all what happened and who is to blame. Contact our Birth Injury Lawyers today to schedule a free consultation. Call Miller Weisbrod, Attorneys At Law today at 214.987.0005 or toll free at 888.987.0005 for a free consultation.