What is fetal distress? Symptoms, Causes and Treatment

Table of Content

• What is fetal distress?

• What causes fetal distress?

• Signs of fetal distress

• Symptoms of fetal distress

• Diagnosis of fetal distress

• Treatment of fetal distress

• Long-term effects of fetal distress

• Can I prevent fetal distress in pregnancy?

• FAQ on What is fetal distress

Introduction 

Fetal distress, also known as non-reassuring fetal status, is a condition during pregnancy or labor in which the fetus shows signs of inadequate oxygenation. It basically means your baby is un well in your womb because it is not getting enough oxygen. Though this can happen anytime during pregnancy but it more common during labor when the mother is applying pressure to deliver the baby. 

To know more about fetal distress, read ahead to know what it is and how it is diagnosed and treated. 

What is fetal distress?

Fetal distress refers to a condition where the fetus shows sign of distress before or during childbirth indicating that the fetus is not well. It happen anytime during pregnancy but is more common during late pregnancy or labor. Most healthcare providers also refer to the term fetal distress as non-reassuring fetal status (NRFS).

Fetal distress is an uncommon complication of labor. It typically occurs when the fetus has not been receiving enough oxygen. Fetal distress can occur due to many reasons like the pregnancy that lasts too long (postmaturity), rapid labor or difficult labor, reactions to medications or issues with the umbilical cord or placenta. Fetal distress can be dangerous and cause complications for both you and the fetus. 

What causes fetal distress?

Fetal distress may occur when the baby doesn’t receive enough oxygen because of problems with the oxygen delivery. Unlike us, your fetus (Baby In the womb) can't breathe using their lungs, rather they depend on their mother for the oxygen to be delivered to them via mothers blood. The oxygen from the mother's blood gets transferred to the baby's blood via the placenta. Anything that interrupts this process may lead to fetal distress.

Other conditions which may lead to non-reassuring fetal status are:

• Too frequent contractions 

• Fetal anemia

• Low amniotic fluid

• Pregnancy-induced hypertension (high blood pressure when you didn't have it before pregnancy).

• Preeclampsia

• Abnormally low blood pressure of the mother

• Late-term pregnancies (prematurity)

• Fetal growth restriction 

• Placental abruption.

• Placental previa

• Umbilical cord compression

• Mother with a chronic condition like diabetes, kidney disease or heart disease.

• Identical twins in womb

Signs of fetal distress

The next question is how to know your baby is in distress. Here are the signs of fetal distress that are diagnosed by your doctor under supervision: 

• The fetus has a decreased heart rate 

• The baby has a different pattern or less fetal movement suddenly 

• Your water breaks and is greenish-brown 

• Less amniotic fluid

Symptoms of fetal distress

The signs of fetal distress are something that can be diagnosed by the doctor,  but how can you know that your baby is unwell. Well, though it's tough, you can identify probable fetal distress by careful monitoring your baby's movement in your womb. If you suspect decreased fetal movement or abnormal fetal movement pattern, it is possible your baby is not doing well in the womb and you should see your doctor soon. 

Diagnosis of fetal distress

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.

To find out if the fetus is performing well with pregnancy and childbirth, one useful tool is to monitor its heart rate. This monitoring can be done continuously or intermittently. This monitoring is done during labor as well as before it whenever you go for your antenatal checkup in the later months of pregnancy to check the well being of the baby. 

To track the fetal heart rate during pregnancy, your physician could suggest further tests:

• Nonstress test: An electronic fetal monitor measures the fetal heart rate while you’re sitting or lying down. An electronic sensor-equipped belt is wrapped across your abdomen. This sensor monitors the fetal heart rate and  it is recorded during that period. Your uterine contractions can also be measured by this test. Depending on how active the fetus is, the outcomes are either reactive or not.

• Biophysical profile: Biophysical profile is an ultrasound that measures fetal movement, muscle tone, breathing movement and amniotic fluid volume. It’s sometimes combined with a nonstress test.

• Electronic fetal heart rate monitor: You wear a device with an attached sensor around your belly continuously during labor and birth. The sensor sends the sounds of the fetal heart to a computer that your doctor monitors for the well being of the baby.

• Doppler devise:  This comprises of a hand-held device which is placed on your belly that detects the fetal heartbeat using sound waves. This is just Luke the use probe. Your obstetrician uses a Doppler throughout your pregnancy, most likely at your routine prenatal checkups.

Treatment of fetal distress

The best treatment of fetal distress is to deliver the baby as soon as possible even if you're not in labor yet. The delivery can be done both vaginally or via c-section. This would be decided by your obstetrician. 

But what if you're already in labor and your baby goes into distress? In that case, there are somethings that your doctor can try, like:

• Changing your position. This may improve the fetus's oxygen supply and blood return to your heart. 

• Providing you with an oxygen mask to breathe from. 

• Supplying fluids via your intravenous line. 

• Using medication to slow down your contractions. 

• Amnioinfusion, a technique used to treat umbilical cord compression in which fluid is infused into the amniotic sac.

You have to understand that the definite care and management for your case would be understood the best by your obstetrician and thus the final strategy in management would be decided by them. Your doctor would explain the management and take your consent so you shouldn't worry much!

Long-term effects of fetal distress

Fetal distress can have some very dangerous long-term effects if not treated immediately. Brain damage, cerebral palsy, or even stillbirth can result from a prolonged oxygen shortage during childbirth caused due to fetal distress.  Here are some potential long-term effects of fetal distress:

• Neurological impairments: Lack of oxygen during fetal distress can lead to brain damage or neurological disorders in the baby, such as cerebral palsy, intellectual disabilities, or developmental delays.

• Learning and behavioural problems: Children who experienced fetal distress can have difficulties with learning, attention, memory, and behavior later in life.

• Cognitive and motor delays: Fetal distress can impair cognitive development and motor skill development, leading to delays in reaching developmental milestones.

• Sensory impairments: Prolonged fetal distress can potentially cause hearing loss, visual impairments, or other sensory deficits.

• Increased risk of chronic conditions: Some studies suggest that fetal distress may increase the risk of developing chronic conditions later in life, such as cardiovascular diseases, metabolic disorders, or respiratory problems.

• Psychological and emotional difficulties: The effects of fetal distress on brain development can sometimes lead to psychological or emotional problems, such as anxiety, depression, or attachment issues.

It's important to know that the severity of these long-term effects can vary depending on the duration and intensity of the fetal distress, as well as the promptness of medical intervention and care provided to mother and baby. 

Can I prevent fetal distress in pregnancy?

Fetal distress is usually not preventable. But you can lower your chance of developing conditions that can result in fetal distress by keeping up with your prenatal visits and leading a healthy pregnancy. Your obstetrician can also detect fetal distress if you talk to them about your pregnancy and labor symptoms.

Take-Home Points

Fetal  distress, also known as non-reassuring fetal status, is a condition during pregnancy or labor in which the fetus shows signs of inadequate oxygenation. There are many reasons that can cause fetal distress even though it's not a very common conditions.  The most important part is recognizing fetal distress - this is done by monitoring the baby’s movement and heart beats. Your doctor can manage this by many ways but the definite management is delivery of the baby. Remember, to keep in mind any cahnge in pattern of your fetus movement and consulting your doctor if you suspect decreased or abnormal movement.