Fetal distress, also known as non-reassuring fetal status, describes a situation where a baby in the womb experiences inadequate oxygen or nutrient supply. This condition can arise during pregnancy or labor. Understanding these indicators is important for expectant parents, enabling timely communication with medical professionals to support the well-being of both the pregnant individual and the baby.
Recognizing Potential Signs
Changes in fetal movement are among the most noticeable signs suggesting distress. While babies have periods of rest, a significant decrease or absence of movement can be concerning. Expectant parents may feel fetal movements, often described as flutters, as early as 18 to 22 weeks, with consistent patterns by 24 weeks.
Tracking fetal activity, known as kick counts, is generally recommended from around 28 weeks. A typical pattern involves feeling at least 10 movements within one to two hours. If the baby’s activity significantly deviates from its usual pattern or if fewer than 10 movements are felt within two hours, medical attention is warranted.
Vaginal bleeding or spotting can also signal complications. While light spotting can occur early in pregnancy due to implantation, any amount of bleeding, particularly heavier bleeding, should be promptly evaluated. Unusual discharge, such as changes in color, consistency, or odor, might suggest an infection or other issues. Additionally, severe abdominal pain or persistent cramping, differing from typical pregnancy discomfort, can indicate serious conditions like placental abruption or, rarely, uterine rupture.
Other physical changes in the pregnant individual can also be signals. Sudden swelling, especially in the face and hands, along with persistent headaches or vision changes like blurred vision or flashing lights, are potential indicators of preeclampsia. Preeclampsia is a blood pressure disorder that can affect organ systems. A fever or chills may also suggest an infection, which could impact the baby.
Underlying Causes
Fetal distress can stem from various factors compromising the baby’s environment. Placental issues are common; for instance, placental abruption involves premature detachment, while placental insufficiency means ineffective nutrient and oxygen delivery. Both restrict the baby’s access to necessary resources.
Umbilical cord problems, such as compression, entanglement, or prolapse (where the cord slips into the birth canal ahead of the baby), can disrupt blood flow and oxygen supply. Maternal health conditions like gestational diabetes, high blood pressure (e.g., preeclampsia), certain infections, and anemia can also contribute.
Rarely, uterine issues like a uterine rupture (where the uterine wall tears) can occur, causing immediate concern. Fetal growth restriction, where the baby is not growing at the expected rate, is another cause, often due to placental problems or other factors affecting nourishment.
When to Contact Your Doctor
It is important to contact a healthcare provider immediately if you observe any concerning changes. These include a significant decrease or absence of fetal movement, any vaginal bleeding, severe or persistent abdominal pain, sudden swelling in the face or hands accompanied by headache or vision changes, or a fever and chills. Timely intervention can significantly influence outcomes.
Medical Assessment and Interventions
Upon seeking medical attention for suspected fetal distress, healthcare providers employ various diagnostic tools to assess the baby’s status. A Non-Stress Test (NST) is commonly used, which monitors the baby’s heart rate in response to its movements. A Biophysical Profile (BPP) evaluates several aspects of the baby’s well-being, including breathing, body movement, muscle tone, amniotic fluid volume, and heart rate patterns from an NST.
Ultrasound imaging provides detailed visual information, allowing providers to assess the baby’s growth, amniotic fluid levels, and overall anatomy. Doppler flow studies are a specialized type of ultrasound that measure blood flow through the umbilical cord and other vessels, indicating if the baby is receiving sufficient blood, nutrients, and oxygen. These studies are particularly helpful when concerns about fetal growth restriction exist.
Based on assessment findings, interventions vary depending on distress severity. If distress is mild, close monitoring may be sufficient, sometimes requiring hospitalization for continuous observation. In some cases, medications may be administered to manage underlying maternal conditions. If distress is severe or persistent, the primary intervention often involves delivering the baby, either through induced labor or a cesarean section, to prevent further complications.