Birth-How Does Fetal Distress Affect The Birth Process

Fetal distress refers to signs that a baby is not coping well in the womb, often due to reduced oxygen supply. This condition can arise during labour or late in pregnancy and can significantly impact the delivery process.

Understanding the causes, signs, and management of fetal distress is essential for ensuring the safety of both the mother and the baby during childbirth.

Fetal distress is a condition in which a baby shows signs of struggling in the womb, often due to insufficient oxygen. This typically occurs during labour but can also develop late in pregnancy.

Causes of fetal distress may include placental issues, umbilical cord prolapse, meconium passage by the baby in utero, or conditions affecting the mother, such as preeclampsia or gestational diabetes. In some cases, a post-mature baby—one who is overdue—may experience fetal distress as the placenta begins to function less effectively.

Prompt recognition and management of fetal distress are essential to avoid complications during birth. Doctors closely monitor for indicators like abnormal fetal distress heart rate patterns and decreased fetal movement, intervening when necessary to ensure the safety of both mother and baby.

Fetal distress refers to the signs indicating that a baby is not coping well in the womb, particularly due to a lack of oxygen. The common causes of fetal distress include

• Umbilical cord compression or prolapse: The cord may wrap around the baby's neck or become compressed, cutting off oxygen.
• Placental insufficiency: The placenta may not provide enough oxygen or nutrients, especially in cases of post-mature babies.
• Meconium in the amniotic fluid: The baby may pass stool (meconium) in the womb, which is often a sign of distress.
• Maternal health conditions: Conditions such as gestational diabetes, preeclampsia, or infections can disrupt oxygen flow to the baby.
   

Identifying the signs of fetal distress during labour or late pregnancy is crucial to ensuring a safe delivery for both mother and baby. Doctors use multiple methods to monitor the baby’s health.

The most common indicator is an abnormal fetal heart rate, monitored through continuous electronic fetal heart monitoring. Fetal distress heart rate patterns such as tachycardia (heart rate exceeding 160 beats per minute) or bradycardia (heart rate below 110 beats per minute) signal potential distress. 

Irregular patterns, like late decelerations during contractions, can also indicate that the baby is struggling. According to a study from the Indian Journal of Paediatrics, these heart rate abnormalities are key markers for early identification of distress.

Another key sign is decreased fetal movement, which can signal that the baby is not receiving enough oxygen. In some cases, meconium in the amniotic fluid is observed, indicating that the baby may have passed stool in response to stress. Research published by the Indian Council of Medical Research (ICMR) shows that meconium-stained fluid occurs more frequently in post-mature babies and is linked to adverse birth outcomes.

Strong or prolonged uterine contractions can also contribute to reduced oxygen supply, further signalling fetal distress. NICE and other studies suggest that uterine hyperstimulation can increase the risk of fetal hypoxia.

Recognising these signs early allows for timely interventions to protect the baby’s well-being.

One of the most reliable indicators of fetal distress is an abnormal heart rate, which is monitored using continuous electronic fetal monitoring during labour. 

These patterns can signal whether the baby is receiving enough oxygen and can help guide timely medical intervention.

• Tachycardia: A fetal heart rate over 160 beats per minute. This may indicate that the baby is under stress or that the mother has a fever or infection.
• Bradycardia: A fetal heart rate below 110 beats per minute, suggesting that the baby may not be receiving enough oxygen.
• Late decelerations: A slowing of the heart rate after a contraction, often indicating poor oxygen transfer from the placenta, which requires immediate medical attention.

Consistently monitoring these patterns allows doctors to make informed decisions about managing fetal distress.

Fetal movements are a reassuring sign of the baby's well-being during pregnancy, especially in the third trimester. A sudden or significant drop in these movements can signal fetal distress, often linked to a lack of oxygen. Doctors may advise mothers to perform "kick counts," tracking movements, as decreased fetal movement is a major sign of distress. 

According to studies by the Royal College of Obstetricians and Gynaecologists (RCOG), a reduction in fetal movement can precede stillbirth in around 55% of cases, emphasising the importance of monitoring movements and seeking medical advice if there is a noticeable decrease.

Meconium in amniotic fluid—the presence of the baby’s first stool in the womb—indicates that the baby may be under stress, possibly due to hypoxia. Meconium-stained fluid occurs in about 10-20% of full-term deliveries, with higher rates among post-mature babies, according to data from the American Academy of Family Physicians (AAFP). This underscores the need for careful monitoring during labour, especially in overdue pregnancies.

Abnormal uterine contractions, particularly those that are overly strong or prolonged, can reduce blood flow to the placenta, limiting oxygen delivery to the baby. Uterine hyperstimulation, seen in 1-2% of labours, may worsen fetal distress, according to the National Institute for Health and Care Excellence (NICE) guidelines. This highlights the importance of careful monitoring of contractions during labour to prevent complications.
 

Diagnosing fetal distress during labour involves continuous monitoring to ensure the baby’s safety. In India, government hospitals and private maternity centres alike use several methods to assess fetal well-being:

• Electronic fetal heart monitoring: A common practice, where the baby’s heart rate is continuously tracked to detect any signs of distress.
• Amniotic fluid analysis: Checking for meconium in amniotic fluid is crucial, as it may indicate stress, particularly in overdue babies.
• Biophysical profile: A combination of ultrasound and heart rate monitoring helps assess the baby’s movements, tone, and overall health, ensuring timely interventions if needed.

This close monitoring is vital for preventing complications and improving neonatal outcomes in India.

Fetal distress can significantly complicate the birth process, often requiring urgent medical interventions to ensure the safety of both mother and baby. When signs of distress such as abnormal heart rates or reduced oxygen supply are detected, immediate action is taken.

Emergency caesarean section (C-section): A C-section is often the first course of action when fetal distress is identified, especially if the baby's oxygen levels are dropping rapidly. This procedure allows for the quickest delivery, preventing complications such as hypoxia, which can lead to long-term developmental issues. 

According to research from the Indian Council of Medical Research (ICMR), emergency C-sections have increased in cases of detected fetal distress, ensuring better neonatal outcomes.

Assisted vaginal delivery: If vaginal delivery is possible but the baby shows signs of distress, doctors may use tools such as forceps or a vacuum extractor to expedite delivery. This method helps avoid prolonged labour, which can further stress the baby.

Prompt interventions help reduce risks and improve outcomes for distressed babies during birth.

Fetal distress, if not managed promptly, can lead to various serious complications for the baby. These complications are often linked to reduced oxygen supply and stress during labour. Timely medical intervention is crucial to prevent long-term health issues or even life-threatening outcomes for the newborn.
 

Recognising fetal distress early can help prevent these complications through timely interventions such as emergency C-sections.

Managing fetal distress requires prompt interventions to prevent complications and safeguard the health of both mother and baby. The first step is often to reposition the mother, as changing her position can improve blood flow to the placenta, thus increasing oxygen supply to the baby. For example, turning the mother onto her side or elevating her legs may help alleviate distress.

Administering oxygen to the mother is another common method, ensuring that the baby receives sufficient oxygen in cases where distress is detected. Intravenous fluids may also be given to the mother to improve circulation and reduce fetal stress.

In more severe cases, or if these initial measures do not relieve the distress, an emergency caesarean section (C-section) is performed. This is often the fastest and safest way to deliver the baby, preventing further complications such as hypoxia or stillbirth.

Timely management of fetal distress is crucial in ensuring positive outcomes for both mother and baby, particularly in high-risk pregnancies.
 

When fetal distress is detected, quick and effective treatment is crucial to ensure the baby’s safety. Several options are available to manage and relieve fetal distress, depending on the severity and stage of labour.

• Maternal repositioning: Adjusting the mother’s position can increase the oxygen supply to the baby.
• Oxygen therapy: The mother may be given oxygen to increase the baby’s oxygen levels.
• Intravenous fluids: Administering fluids to the mother can help improve circulation and reduce the baby’s stress.
• Medications: In some cases, medications can be used to slow down labour or reduce contractions.
• Emergency C-section: If the distress continues, immediate delivery by C-section may be the safest option.

These interventions are implemented swiftly to mitigate the risks associated with fetal distress.

Fetal distress is a serious condition that can affect the birth process and the health of both mother and baby. Early recognition and prompt management are essential to prevent complications such as hypoxia, stillbirth, or developmental issues.

Monitoring key signs like abnormal heart rate patterns and decreased fetal movement allows doctors to take swift action. Understanding and addressing fetal distress quickly ensures safer deliveries and better outcomes for both the mother and baby, especially in high-risk pregnancies.