The days leading to the due date of a child's birth are usually filled with excitement and anticipation. The nursery is decorated, diapers are laid out and the car seat is installed so that everything is ready when the new baby arrives home. Unfortunately for some parents, delivery isn't followed by a speedy return home, but by time spent in the neonatal intensive care unit because something went wrong during delivery.
There are various complications that can lead to the need for extra care, one of which is fetal distress syndrome. Although not common, the National Institute of Health estimates five to ten percent of births are accompanied with fetal distress complications.
When left untreated, fetal distress can lead to birth injuries and even death. However, early recognition and evaluation can allow a physician to recognize the warning signs of fetal distress and deliver an infant before irreversible birth injuries result.
Fetal Distress Defined
Disputes over the exact definition of fetal distress led the American Congress of Obstetricians and Gynecologists (ACOG) to issue a report stating physicians who use the imprecise and nonspecific term are required to provide further description.
Most doctors use the term to refer to "a state where insufficient oxygen is reaching the fetus." This can occur either during pregnancy or during labor and generally requires further explanation, as recommended by ACOG, detailing the fetal heart rate.
Various factors can contribute to fetal distress. Two common causes before labor are vigorous fetal activity and placental abruption. Placental abruption occurs when the placenta detaches from the mother's uterus. Distress during labor is commonly caused by cord compression resulting from the umbilical cord wrapping around a limb, neck or other portion of the infant.
In addition, rapid contractions can also lead to fetal distress. Although it can occur naturally, it is also linked to the use of oxytocin. Oxytocin is used by physicians to stimulate the uterus and trigger labor. This stimulation can result in prolonged contractions that may reduce the blood flow to the placenta.
How Doctors Can Recognize Fetal Distress
If suspected, a doctor can take many steps to investigate. One involves use of a fetal heart monitor. A strong, stable heartbeat is a clear sign that a baby is doing well during pregnancy and delivery. A faltering heartbeat is a sign of fetal distress.
A fetal heart monitor can be used both internally and externally. External monitoring uses electrodes placed on the mother's abdomen to detect the heart rate. Internal monitoring requires placement of an electrode through the cervix directly on the fetus' scalp. Most obstetric units monitor fetal heart rates throughout the delivery process.
If the fetal heart rate is suspicious, blood from the infant is analyzed to determine if there is an oxygen deficiency. If positive for the deficiency, delivery is expedited through the use of either an assisted labor or cesarean section.
Concerns are also present when the fetus exhibits a reduction or cessation in response to stimuli and passes the first stool while still in utero. This stool is referred to as meconium, and passing it in the uterus can lead to meconium aspiration. Meconium aspiration is a respiratory disorder that makes it difficult for the infant to breath.
Proper Responses to Signs of Fetal Distress
There are many proactive measures doctors can take to reduce the symptoms of fetal distress. One simple step involves shifting the mother's position. At times, increased blood flow to the infant will result when the mother is shifted out of a position that put excessive pressure on the vessels supplying the placenta.
In situations where the stress is a result of oxytocin use, an obstetrician should stop the infusion. If the uterus began excessively contracting naturally, use of a tocolytic drug can ease the contractions and provide an opportunity for blood flow to return to normal.
If the infant is delivered and appears lethargic, potentially from aspirating meconium passed while in distress, the physician should promptly do the following:
- Clear the infant's airways
- Provide oxygen
- Suction of airways if needed
- Repeat until baby's heart rate stabilizes
Once stabile, the child should be closely monitored.
Results of Inappropriate Physician Response
A physician's prompt response is crucial to successfully navigating fetal distress issues. If a doctor hesitates, permanent brain damage may result. This complication is rare because it can be the result of severe and prolonged oxygen deprivation.
Although rare, these and other birth injuries do happen. If you or a loved one suffered from brain or other injuries connected to a poorly managed delivery, remedies are available. Compensation for medical and rehabilitative costs as well as pain and suffering may apply. Discuss your situation with an experienced Memphis medical malpractic attorney to ensure all your legal rights and remedies are protected.