A fetus experiences fetal distress (or non-reassuring fetal status) when it has changes in heart rate, movement or signs of oxygen deprivation before or during labor.
Fetal distress describes a condition when the fetus shows signs of distress during late pregnancy or labor. Most healthcare providers have replaced the term fetal distress with non-reassuring fetal status (NRFS). There are many reasons why the fetus could show signs of distress, such as 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. Your obstetrician looks for signs of distress as part of your pregnancy care.
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The most common signs of fetal distress are:
The most common cause of fetal distress is the fetus not getting enough oxygen. The fetus gets oxygen from you. You breathe oxygen into your lungs, then your blood carries it to the placenta. It’s handed off to the placenta and transferred to the fetus's blood. Anything that interrupts this process may lead to fetal distress.
Other conditions that may lead to non-reassuring fetal status are:
Your pregnancy care provider diagnoses fetal distress by reading the fetal heart rate. A low heart rate, or unusual patterns in the heart rate, could signal fetal distress. Checking the fetal heart rate is a good way to find out if it's tolerating pregnancy and labor well.
During pregnancy your obstetrician may recommend other tests to monitor the fetal heart rate:
During labor, your obstetrician monitors the fetal heart rate either continuously or intermittently. Continuous monitoring means you wear a device around your belly that reads the fetal heart rate at all times (this is the most common method). Intermittent monitoring means your provider checks the fetal heart rate at set times (like every 30 minutes).
The two most common ways to monitor fetal heart rate for fetal distress are:
If you’re in labor, some of the things your obstetrician may do to help during fetal distress include:
If your baby is in trouble, your provider may need to deliver it right away. They may use forceps or a vacuum extractor if you're fully dilated and the baby is low enough in your uterus. Otherwise, they may need to perform an emergency c-section. Your provider will talk you through what is happening and why they are concerned. They will ask for your consent before any procedure.
Fetal distress can have lasting effects on your baby. Prolonged lack of oxygen during delivery can lead to brain injury, cerebral palsy or even stillbirth. If your baby is in distress, your provider will make every attempt to deliver your baby safely and before severe complications arise.
There's usually nothing you can do to prevent fetal distress. However, attending all of your prenatal appointments and maintaining a healthy pregnancy can help decrease your risk of conditions that lead to fetal distress. Additionally, discussing your pregnancy and labor symptoms with your obstetrician can help them identify fetal distress. For example, pay attention to fetal movement and let your provider know about vaginal bleeding, gushes of vaginal fluid or continuous and frequent contractions.
If your baby is in distress, listening to your obstetrician and following their instructions is important. Don't be afraid to ask them what's going because sometimes things change quickly. In most cases, your provider will rely on you to let them know how you're feeling.
A note from Cleveland Clinic
Obstetricians know how to spot a baby experiencing distress during pregnancy and labor. Listening to the fetal heart rate and noting signs like decreased movement are ways to detect non-reassuring fetal status (fetal distress). Sometimes your baby may need to be delivered sooner to prevent serious complications. Listening to your body and telling your provider about your pregnancy and labor symptoms is the best thing you can do to lower the risk of fetal distress.
Last reviewed by a Cleveland Clinic medical professional on 08/11/2022.
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