Fetal distress

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

In medicine (obstetrics), fetal distress is the presence of signs in a pregnant woman—before or during childbirth—that the fetus is not well or is becoming excessively fatigued.

Signs and symptoms of fetal distress include:

• Decreased movement felt by the mother
• Meconium in the amniotic fluid
• Cardiotocography signs
  • increased or decreased fetal heart rate (tachycardia and bradycardia), especially during and after a contraction
  • decreased variability in the fetal heart rate
• Biochemical signs, assessed by collecting a small sample of baby’s blood from a scalp prick through the open cervix in labour
  • fetal acidosis
  • elevated fetal blood lactate levels indicating the baby has a lactic acidosis

There are many causes of fetal distress:

• Breathing problems
• Abnormal position and presentation of the fetus
• Multiple births
• Shoulder dystocia
• Prolapsed umbilical cord
• Nuchal cord
• Placental abruption

In many situations fetal distress will lead the obstetrician to recommend steps to urgently deliver the baby. This can be done by induction, or in more urgent cases, a caesarean section may be performed.

Fetal distress is considered an absolute contraindication to the use of the following medications:

• Oxytocin

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