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Fetal Distress

This document discusses fetal distress, also known as nonreassuring fetal status. It defines fetal distress as fetal hypoxia caused by lack of oxygen and excess carbon dioxide. Causes can be maternal like anemia, placental like preeclampsia, or fetal like compression during labor. Signs include abnormal heart rate patterns, meconium passage, and fetal acidosis. Diagnosis involves tests like non-stress tests and monitoring fetal heart rate. If not treated promptly, fetal distress can cause injury or death to the baby like cerebral palsy. Management includes stopping oxytocin, repositioning the mother, giving oxygen, and expedited delivery by C-section if conservative measures don't improve the baby's condition

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Amira Attya
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1K views

Fetal Distress

This document discusses fetal distress, also known as nonreassuring fetal status. It defines fetal distress as fetal hypoxia caused by lack of oxygen and excess carbon dioxide. Causes can be maternal like anemia, placental like preeclampsia, or fetal like compression during labor. Signs include abnormal heart rate patterns, meconium passage, and fetal acidosis. Diagnosis involves tests like non-stress tests and monitoring fetal heart rate. If not treated promptly, fetal distress can cause injury or death to the baby like cerebral palsy. Management includes stopping oxytocin, repositioning the mother, giving oxygen, and expedited delivery by C-section if conservative measures don't improve the baby's condition

Uploaded by

Amira Attya
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Fetal Distress (Nonreassuring Fetal Status) 1.

Definition :
Fetal suffering from: lack of oxygen, increase co2 and decrease ph(7.2) The term "fetal distress" is commonly used to describe fetal hypoxia
2.

Etiology:
Maternal causes:
1. Anemia 2. Excessive He. 3. Pulmonary disease 4. Heart failure and shock 5. Cyanide and barbiturate poisoning Placental causes: 1. Compression of the placenta as in prolonged or obstructed labor 2. Premature separation of the placenta as in case of placenta previa or abruption placenta 3. Placental insufficiency as in preeclampsia, chronic renal disease, DM and post maturity Umbilical cord causes: 1. A true knot, or tight coiling of the cord around d the fetus 2. Compression of prolapsed cord 3. Compression of the cord by the forceps 4. Rupture of the vasa previa Fetal causes: 1. Prolonged compression or excessive moulding of the fetal head during labor caused by contracted pelvis, forceps or rigid periperium

3. Path physiology:
1. 2. 3. 4. Decrease maternal blood flow Decrease maternal blood oxygen Decrease placental blood flow Decrease placental blood oxygen Due to decrease oxygen in the blood, the compensatory mechanism lead to increase oxygen supply to the brain and decrease oxygen supply to different body organs In GIT (compensatory mechanism)-

Decrease the intestinal size or surface by increase intestinal movement and relaxation of the anal sphincter With the continues decrease in placental oxygen lead to decrease fetal waste removal leads to increase intestinal movements ( reverse) from down to up lead to vomiting of meconium

In the brain ( the compensatory mechanism)- lead to decrease oxygen demand lead to formation of caput succedaneum to decrease oxygen to the skin and hair lead to increase moulding of the head bones to decrease surface demand for oxygen

4. Signs and Symptoms:


A. Ante partum period:
kick count less than 10 kicks with bleeding or excessive fetal movement

B. Intrapartum period:
Tachycardia & Bradycardia especially during contractions Excessive or decrease in FHR . tachycardia >160 or bradycardia <100 Passage of Meconium in cephalic presentation Due to increase intestinal movements and relaxation of anal sphincter caused by hypoxia Fetal acidosis detected by taking blood sample from fetal scalp during labor. Ph >7.2 indicates fetal acidosis due to hypoxia Elevated fetal blood lactate levels lactic acidosis Excessive formation of caput succedenium Excessive formation of moulding

5. Diagnosis:
Non-stress Test Ultrasound Cardiotocography Fetal blood sampling scalp prick

6. Complication: if fetal distress not treated may cause


1.

2. 3.

serious injury or death of the baby cerebral palsy seizures and mental retardation

7. Fetal distress management:


When fetal distress is present, immediate action must be taken to restore proper blood supply and oxygenation to the baby. If there are signs of fetal distress, the healthcare provider may choose to deliver the baby immediately (often by cesarean section). Often, however, he or she will take other steps first to try to improve and confirm the baby's condition. alteration of maternal position stop of oxytocin infusion hydration oxygen administration checked for meconium fetal scalp stimulation
3

amnioinfusion

If conservative measures are unsuccessful, immediate delivery of the baby (often by cesarean section) is required. In certain situations, it may be appropriate to resuscitate the baby in the uterus before performing the cesarean delivery: use of medication The fetus must continue to be monitored closely for signs that the treatment is not working, which would require the immediate commencement of the cesarean delivery. The negligence of a healthcare provider to implement an appropriate treatment plan can result in permanent injury, or even death, to baby and mother.

8. Nursing role:
1. Stop oxytocin 2. Reposition the patient : put the mother in lateral Rt.side position 3. Give oxygen to the mother 4. Check FHR 5. P.V examination

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