Distress

1. FETAL DISTRESS
Dr.Regan,
MD

2. Learning tasks
At the end of this session student must be able to;
a. Define fetal distress
b. Identify causes/etiology of fetal distress
c. Describe pathogenesis of fetal distress
d. Describe clinical features and complications of fetal distress
e. Establish provisional diagnosis and differential diagnoses of fetal distress
f. Treatment of fetal distress
g. Prevention of fetal distress
h. Referral system

3. Introduction
Fetal distress;
Is a depletion of oxygen and accumulation of carbon dioxide leading to state of
hypoxia and acidosis during intra-uterine life.

4. Etiology of fetal distress
Microvascular ischemia (pregnancy hypertension)
Low oxygen carried by RBC due to severe anemia
Acute bleeding (placenta Previa or abruption placenta)
Maternal infection
Dysfunction of placenta
Intrauterine infection
Obstructed umbilical blood flow due to prolapse
DM
Asthma
Post term pregnancies
Labour induction or augmentation
Maternal supine position

5. Pathogenesis
Due to hypoxia, Accumulation of carbon dioxide
• Hence Respiratory acidosis
• The Increases FHR later on decreases of FHR
• Intestinal peristalsis
• Lead relaxation of the anal sphincter
• Meconium aspiration
• Later on Fetal or neonatal pneumonia

6. Clinical features
Meconium staining of the amniotic fluid
Fetal heart rate
Fetal tachycardia >160 bpm severe tachycardia >180bpm
Fetal bradycardia <120bpm severe bradycardia <80bpm
Fetal acidosis
Fetal blood sample; PH < 7.20
PO2 <10mmhg (15- 30mmmhg)
PCO2 >60mmhg (35- 55mmhg)

7. Complications
IUGR
IUFD
Hypoxic ischemic encephalopathy
Meconium aspiration syndrome
Cerebral palsy
Neonatal seizures

8. Diagnosis
Presence of the following;
Abnormal fetal heart rate pattern
Presence of meconium
Decreases in fetal PH

9. Differential diagnoses
Cord prolapse
Placenta Previa
Vasa Previa
Chorioamniotis
Abruptio placenta
Post term pregnancies

10. Treatment
Turn the woman on her side
Administer oxygen (6-8L/min) to improve fetal oxygen
Check pulse, BP and temperature of the mother
Correct hypotension by giving crystalloids
Immediately delivery by cesarean section or instrumental delivery

12. Prevention
Monitor of the mother and fetus prior to birth by using partograph
Monitor fetal heart rate
Control maternal pressure or infection

13. THE END
THANK YOU…!!!