Fetal Distress

Fetal distress is a broad term used to describe abnormalities in the fetal heart rate. It typically means there’s concern that a fetus isn’t getting enough oxygen during late pregnancy or labor. Most healthcare providers use the term “non-reassuring fetal status (NRFS)” instead.

Fetal distress can happen for many reasons. Examples include a fast labor and issues with the umbilical cord or placenta. Your pregnancy care provider looks for signs of distress mainly through fetal heart rate monitoring.

“Fetal distress” is a vague term. And experts don’t have a specific definition for non-reassuring fetal status. You can think of it more as a sign of an underlying issue. The issue may be mild and cause a brief lack of oxygen. Or it may be serious and cause a long-term oxygen blockage to the fetus.

Because of the potential for severe complications, most healthcare providers take NRFS seriously. If your baby shows signs of distress, your care team will act quickly to resolve it. Don’t hesitate to ask them what’s going on. Sometimes, things change quickly.

Signs of fetal distress

The most common signs of fetal distress are:

• Slow fetal heart rate (FHR)
• Repeated late or variable decelerations (brief decreases in the FHR related to contractions)
• Less fetal movement than usual

You can’t feel fetal heart rate changes. Only your healthcare provider can tell if heart rate readings are abnormal. If you notice less movement or fewer kicks than usual, contact your provider right away.

Fetal distress causes

The main cause of fetal distress is a lack of oxygen. The fetus gets oxygen from you through the placenta and umbilical cord. Anything that disrupts this transfer can lead to fetal distress. Some examples include:

• Placental abruption
• Too frequent contractions
• Umbilical cord compression
• Umbilical cord prolapse
• Very low blood pressure in the mother

Some conditions that may increase the risk of fetal distress include:

• Low amniotic fluid
• Late-term pregnancies (41 weeks or more)
• Multiples pregnancy
• Placenta previa
• Preeclampsia
• Intrauterine growth restriction
• Maternal chronic conditions like diabetes, kidney disease or heart disease

Complications of this condition

A prolonged lack of oxygen to the fetus can lead to:

• Hypoxic-ischemic encephalopathy
• Cerebral palsy
• Seizures
• Stillbirth

Your provider will make every attempt to deliver your baby safely and prevent these complications.

How doctors diagnose this condition

Your pregnancy care provider diagnoses fetal distress by reading the fetal heart rate (FHR). They use fetal heart rate monitoring during pregnancy appointments and labor. Your provider may use other tests, like an ultrasound or a biophysical profile, to find the cause of it.

How is it treated?

At the first signs of fetal distress during labor, your care team may use certain methods to help fix it. These include:

• Position changes
• IV fluids
• Medicine to slow or stop contractions
• Adding amniotic fluid to your uterus

These methods fix most mild issues causing fetal distress.

If there’s severe or prolonged fetal distress, you may need an emergency delivery. Your provider may use forceps or a vacuum if you’re fully dilated and the baby is low enough in your uterus. Or they may need to do an emergency C-section.

Your provider will talk you through what’s happening and why they’re concerned. They’ll ask for your consent before any procedure.

What can I expect?

It’s difficult to predict how fetal distress may affect your baby. Most infants with a diagnosis of fetal distress during labor are healthy at birth. Babies with complications like brain damage are more likely to have had oxygen issues during pregnancy, not during labor.

Your care team will be your guide. If there’s concern for fetal distress during labor, a pediatric team will do a thorough health evaluation right after your baby is born.

Can this be prevented?

There’s usually nothing you can do to prevent fetal distress. But attending all your prenatal appointments and maintaining a healthy pregnancy can help decrease the risk of conditions that lead to it.

Tell your pregnancy care provider about your pregnancy and labor symptoms. It can help them identify fetal distress. For example, pay attention to fetal movement. Let your provider know about vaginal bleeding, gushes of vaginal fluid or continuous and frequent contractions.