Identifying and Acting on Fetal Distress During Birth

Going through labor and childbirth is not easy, even when everything goes as hoped. You trust that your obstetrician and support staff are prepared to address any complications that may arise. You trust that your birthing team has been trained properly, will follow all protocols and procedures, and know exactly what to do should anything go wrong. Sadly, not every healthcare professional meets the medical standards that are required of them. When a doctor or nurse is negligent, they can cause serious and lasting birth traumas to newborn babies. One such situation where exceptional care is required is when fetal distress occurs. Medical professionals are expected to know how to identify fetal distress and respond appropriately.

Fetal distress is a condition wherein a fetus exhibits symptoms of distress during late-stage pregnancy or labor. Today, the term fetal distress has largely been replaced with non-reassuring fetal status. There are numerous reasons why a fetus may display signs of distress, including reactions to medications, labor, or problems with the placenta or umbilical cord. Non-reassuring fetal status has the potential to be dangerous and can easily cause serious complications for both the mother and her baby. Your obstetrician should routinely check for indications of fetal distress throughout your pregnancy.

What Are the Symptoms of Non-Reassuring Fetal Status?

Some common symptoms of fetal distress include: 

• A fetal heart rate that is much higher or lower than normal
• Reduced fetal movement over a period of time
• Oligohydramnios (insufficient amniotic fluid)

Why Does Non-Reassuring Fetal Status Occur?

A lack of oxygen to the baby is the most common cause of fetal distress. A fetus gets its oxygen from its mother. She inhales oxygen into her lungs, and from there, her blood carries it to the placenta. It then passes through the placenta and is passed into the fetus's blood. Any disruption to this process can result in fetal distress.

Other medical conditions that can result in non-reassuring fetal status or fetal distress include:

• Uterine tachysystole (excessively frequent uterine contractions)
• Fetal anemia
• Oligohydramnios
• Pregnancy-induced hypertension (high blood pressure that did not exist pre-pregnancy)
• Preeclampsia (a multisystem condition specific to pregnancy that is typically associated with proteinuria and raised blood pressure)
• Unusually low blood pressure
• Late-term pregnancies (more than 40 weeks)
• Fetal growth restriction 
• Placental previa
• Placental abruption
• Compressed umbilical cord
• Chronic medical conditions such as heart disease, kidney disease, or diabetes
• Carrying multiple births (twins, triplets, etc.)

How is Non-Reassuring Fetal Status Diagnosed?

An obstetrician can diagnose non-reassuring fetal status by reading the fetus’s heart rate. Abnormal patterns in the heart rate, or a low heart rate, can indicate fetal distress. Monitoring the fetus’s heart rate is a reliable method of determining how it is tolerating pregnancy and labor.

During pregnancy, your doctor may order additional tests to observe the heart rate, such as:

• Nonstress test: During a nonstress test, an electric fetal monitor calculates the fetal heart rate while you are lying or sitting down. A belt outfitted with a Doppler ultrasound transducer is fastened around the expectant mother’s belly, where it measures and records the fetal heart rate. A nonstress test can also measure your uterine contractions through the use of a tocodynamometer. Depending on how much fetal activity is recorded, the results will be either reactive or not reactive. 
• Biophysical profile: This is an ultrasound that evaluates muscle tone, fetal movement, amniotic fluid volume, and breathing movement. It can be used in conjunction with a nonstress test.

Based on your specific circumstances, your obstetrician will monitor your fetus’s heart rate either intermittently or constantly while you are in labor. Constant monitoring involves wearing an electronic device around your stomach that continuously reads the fetal heart rate. Intermittent monitoring means that your doctor will check the fetal heart rate at predetermined intervals, such as every hour. 

The most common ways to track fetal heart rate for signs of fetal distress are:

• Electronic fetal heart rate monitor: You wear a device with a sensor attached strapped to your belly non-stop during labor and delivery. It transmits the sound of the baby’s heart to a computer, where it is read and interpreted by a member of your birthing team. 
• Doppler device: A hand-held device is placed on your stomach, where it can detect your baby’s heartbeat via sound waves. A Doppler will be used throughout your pregnancy, most likely during regular prenatal checkups.

How is Non-Reassuring Fetal Status Treated?

Once you are in labor, there are several things your obstetrician can do to alleviate fetal distress. They include:  

• Rearrange you to increase the flow of blood returning to your heart and oxygen to the fetus
• Fit you with an oxygen mask
• Administer subcutaneous fluids (IV drip)
• Administer medication to stop or slow contractions
• Amnioinfusion (alleviating umbilical cord compression by introducing saline or sodium lactate into your uterus through a catheter)  

If your baby is in serious distress, your doctor might have to deliver it immediately. If the baby is sitting low enough in your uterus and you are fully dilated, this may be accomplished with the use of a vacuum extractor or forceps. If not, an emergency C-section will need to be performed. Your doctor should talk you through everything that is going on and why they have cause for concern.  

Talk to a Dallas Birth Injury Lawyer About Fetal Distress

Fetal distress that is not promptly identified and properly addressed can have a permanent impact on your child. A lack of oxygen during childbirth can result in cerebral palsy, brain injury, and stillbirth. If your baby is showing signs of distress, your doctor should make every effort to deliver them safely and before serious problems arise.

If your baby sustained injuries due to improperly treated non-reassuring fetal status, you may be eligible for compensation. To determine if you have a viable birth injury case, contact an experienced lawyer who specializes in birth injury cases. The Dallas birth injury lawyers at Rasansky Law Firm can review your medical records, determine if negligence was committed, and file a lawsuit seeking maximum compensation on your behalf. Call (214) 651-6100 to schedule your free consultation.