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Sign of Fetal Distress

Inc. Fetal Heart Rate

By: Okky

Proud College Student of UPN

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Definition

In medicine (obstetrics), fetal distress is the

presence of signs in a pregnant woman

before or during childbirththat the fetus is

not well or is becoming excessively fatigued.

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Signsand symptoms

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 aftera contraction

decreased variability in the fetal heart rate

Biochemical signs, assessed by collecting a small sample ofbaby's blood from a scalp prick through the open cervix in

labour fetal acidosis

elevated fetal blood lactate levels indicating the baby hasa lactic acidosis

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More Info

Some of these signs are more reliable predictorsof actual distress than others. For example,cardiocartography can give high false positiverates, even when interpreted by highly

experienced medical personnel. Acidosis is ahighly reliable predictor, but is not alwaysavailable. A highly effective method ofassessment of distress would be to use fetal heart

rate as a first indicator of distress, to beconfirmed with a more reliable method ofdiagnosis before radical treatment is performed.

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Causes

Breathing problems

Abnormal position and presentation of the fetus

Multiple births

Shoulder dystocia

Prolapsed umbilical cord

Nuchal cord

Placental abruption

Premature closure of the fetal ductus arteriosus

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Risk Factors

Women with a history of: Stillbirth

Intrauterine growth retardation

Oligohydramnios or polyhydramnios

Multiple pregnancies Rhesus sensitisation

Hypertension

Diabetes and other chronic diseases

Decreased fetal movements

Post-term pregnancy. There is some evidence that maternal age over 35 years is

an independent risk factor for uteroplacental insufficiencyand fetal distress

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Treatment

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.

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Fetal Heart Rate

Normal range at term is 120-160 bpm.

Fetal bradychardia (160bpm) may be associated with hypoxia but

several other factors can cause tachycardia, e.g.maternal pyrexia or dehydration.

Late decelerations, defined as uniform,repeated,periodic slowing of the fetal heart rate, whose

onset is from mid to end of the contraction, withits nadir more than 20 seconds after the peakintensity of the contraction, suggest fetal hypoxia.

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