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Fetal Distress: Lin Qi de 2005.9.5

Fetal distress is defined as hypoxia and acidosis in the fetus during pregnancy. It can be caused by maternal factors like anemia or infection, placental or umbilical issues restricting blood flow, or fetal abnormalities. This leads to respiratory acidosis and changes in fetal heart rate. Acute distress causes tachycardia or bradycardia while chronic distress results in intrauterine growth retardation. Clinical signs include meconium staining and abnormal fetal heart patterns. Management involves treating any underlying causes, correcting acidosis, and timely delivery by forceps or c-section if fetal heart rate is abnormal or meconium staining is severe.

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179 views16 pages

Fetal Distress: Lin Qi de 2005.9.5

Fetal distress is defined as hypoxia and acidosis in the fetus during pregnancy. It can be caused by maternal factors like anemia or infection, placental or umbilical issues restricting blood flow, or fetal abnormalities. This leads to respiratory acidosis and changes in fetal heart rate. Acute distress causes tachycardia or bradycardia while chronic distress results in intrauterine growth retardation. Clinical signs include meconium staining and abnormal fetal heart patterns. Management involves treating any underlying causes, correcting acidosis, and timely delivery by forceps or c-section if fetal heart rate is abnormal or meconium staining is severe.

Uploaded by

Rendy Chandra
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Fetal distress

LIN QI DE 2005.9.5

Definition
Fetal distress is defined as depletion of oxygen and accumulation of carbon dioxide,leading to a state of hypoxia and acidosis during intrauterine life.

Etiology
Maternal factors
1) Microvascular ischaemia(PIH) 2) Low oxygen carried by RBC(severe

anemia) 3) Acute bleeding(placenta previa, placental abruption) 4) Shock and acute infection 5) obstructed of Utero-placental blood flow

Etiology
Placentaumbilical factors
1) Obstructed of umbilical blood flow

2) Dysfunction of placenta
3) Fetal factors 4) Malformations of cardiovascular system

5) Intrauterine infection

Pathogenesis
Acute fetal distress

Hypoxiaaccumulation of carbon dioxide Respiratory Acidosis FHR FHR FHR Intestinal peristalsis Relaxation of the anal sphincter Meconium aspiration Fetal or neonatal pneumonia

Pathogenesis
Chronic Fetal distress IUGR
(intrauterine growth retardation)

Clinical manifestation
Acute fetal distress
(1)FHR FHR>180 beats/min (tachycardia) <100 beats/min (bradycardia) (LD) Repeated Late deceleration Placenta dysfunction (VD) Variable deceleration Umbilical factors

FHR:120~160 bpm / FHR variability

Early decelerationED

Late decelerationLD

Variable decelerationVD

Clinical manifestation
Acute fetal distress
(2) Meconium staining of the amniotic fluid grade IIIIII (3) Fetal movement Frequentlydecrease and weaken (4) Acidosis FBS (fetal blood sample)

pH<7.20
pO2<10mmHg (15~30mmHg) CO2>60mmHg (35~55mmHg)

Clinical manifestation
Chronic fetal distress
(1) Placental function (24h E3<10mg or E/C<10) (2) FHR (3) BPS (4) Fetal movement (5) Amnioscopy

Management

Remove the induced factors actively


Correct the acidosis:
5%NaHCO3 250ML

Terminate the pregnancy


(1) FHR>160 or <120 bpm

meconium staining (II~III) (2) Meconium staining grade III amniotic fluid volume<2cm (3) FHR<100 bpm continually

Management

Terminate the pregnancy


(4) Repeated LD and severe VD (5) Baseline variability disappear with LD (6) FBS pH<7.20

Forceps delivery Caesarean section

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