Fetal distressPRESENT

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Fetal distress:

Fetal distress Ethar Elrashid

Definition :

Definition Fetal distress is defined as depletion of oxygen and accumulation of carbon dioxide , leading to a state of “ hypoxia and acidosis ” during intra-uterine life.

Etiology :

Etiology Maternal factors: Microvascular ischaemia (PIH) Low oxygen carried by RBC(severe anemia) Acute bleeding(placenta previa , placental abruption) Shock and acute infection obstructed of Utero -placental blood flow

Etiology Placenta、umbilical factors :

Etiology Placenta 、 umbilical factors Obstructed of umbilical blood flow Umbilical cord prolapse Nuchal cord 2.Dysfunction of placenta: Placental abruption 3.Fetal factors: Abnormal position and presentation of the fetus Multiple births Shoulder dystocia )

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4. Malformations of cardiovascular system 5. Intrauterine infection

Clinical manifestation:

Clinical manifestation (1)FHR >180 beats/min (tachycardia) <100beats/min ( bradycardia ) (2) Meconium staining of the amniotic fluid (3) Fetal movement Frequently→ decrease and weaken

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(4) Acidosis FBS (fetal blood sample) pH<7.20 pO 2 <10mmHg (15~30mmHg) CO 2 >60mmHg (35~55mmHg)

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The cause of the fetal distress Altered blood supply to the fetus Impaired supply of O2 to the fetus Agitation of fetus due to lack of O2 Meconium Staining Tachycardia Constriction of fetal peripheral vessels Initiation of hypoxemia Fetal fatigue Elevated BP Bradycardia Compromised respiration Anaerobic glucose metabolism Fetus aspirates meconium Elevated lactate concentration High-energy phosphates decrease in cerebrum Fetal brain damage or Death

METHODS OF MONITORING FETAL HEART RATE :

METHODS OF MONITORING FETAL HEART RATE AUSCULTATION OF FETAL HEART RATE Optimally, ausculatation of the fetal heart is performed every 15 minutes after a uterine contraction during the first stage of labor, and at least every 5 minutes in the second stage of labor.

CONTINUOUS ELECTRONIC FETAL MONITORING:

CONTINUOUS ELECTRONIC FETAL MONITORING reporting of the FHR and uterine contractions (FHR-UC) The FHR-UC record can be obtained using external transducers that are placed on the maternal abdomen. This technique is used in early labor. Internal monitoring is carried out by placing a spiral electrode onto the fetal scalp to monitor heart rate and placing a plastic catheter transcervically into the amniotic cavity to monitor uterine contractions

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External electronic fetal monitoring : In this method, your health care provider straps an ultrasound transducer over WOMEN abdomen that will pick up the baby's heartbeat

FETAL DISTRESS MANAGEMENT:

FETAL DISTRESS MANAGEMENT first to try to improve and confirm the baby's condition. alteration of maternal position hydration oxygen administration 2. If the mother is receiving oxytocin stop giving it. 3 . Remove the induced factors actively

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4.Correct the acidosis: 5%NaHCO 3 250ML 5.If conservative measures are unsuccessful, immediate delivery of the baby (often by cesarean section) is required