10 Signs of Fetal Distress

All expectant parents hope for an uncomplicated pregnancy, an easy birth, and a healthy baby. Trying to handle the changes that your body goes through during pregnancy is difficult to deal with. When complications arise we question what is occurring in the uterus (or womb) and if what we are feeling is normal. Fetal distress can be described as the detection of an abnormal fetal heart rate or what happens when your baby’s oxygen supply is compromised. This type of distress can be caused by many factors including the mother’s health, fetal infection, and pressure on the umbilical cord. The exact incidence of fetal distress is not known and numbers can range anywhere from 1 in every 25 births to 1 in every 100 births.

Fetal Heart Rate: The earliest indicator of fetal distress is normally identified as an abnormal heart rate pattern in the fetus. There is usually a marked increase (tachycardia) or decrease (bradycardia) in the baby’s heart rate. The umbilical cord may also become compressed or twisted causing a reduction in heart rate and oxygenation to the major organs. The baseline for a normal fetal heart rate is anywhere from 120 – 160 beats per minute. It is normal for a baby’s heart rate to change during uterine contractions. It should be noted that the gender of the baby does not make a difference in terms of fetal heart rate.

Vaginal Bleeding or Spotting: The first thing that comes to mind when an expectant mother begins to spot or bleed is miscarriage. It is important to be able to differentiate between spotting and bleeding. Spotting is the same type of very light bleeding you experience at the beginning and end of your menstrual cycle. Approximately 3 to 4% of all pregnancies will experience bleeding late in the pregnancy. The most common cause of vaginal bleeding during pregnancy is an underlying problem with the placenta. If bleeding becomes painful and lasts for more than a few days you should notify your obstetrician or gynecologist.

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Cramping: Cramping during pregnancy is moderately common but can either be a sign of an essential problem or just a uterus that is stretching. Expectant mothers will frequently experience constipation and flatulence (gas) early during their pregnancy and both of these can cause a significant amount of discomfort. Cramping, however, can also be a warning signal of miscarriage or an ectopic pregnancy. Because it is hard to tell if cramping is a normal part of your pregnancy or could be a sign of danger, any cramping should be discussed with your physician.

Meconium: Meconium, a baby’s first stool, contains intestinal cells, mucus, bile, amniotic fluid, and water and has the consistency of sticky tar. It is sterile, unlike later feces, and has no odor. Meconium Aspiration Syndrome (also known as MAS) happens when a newborn inhales a combination of meconium and amniotic fluid causing a partial or complete blockage of the airways. It occurs in approximately 5 – 10% of all births in the United States and is thought to be a leading cause of acute illness and death in newborns.

High Blood Pressure: High blood pressure during pregnancy is known as gestational hypertension and occurs unexpectedly in approximately 5% of expectant mothers who have no history of blood pressure problems. The risk of developing high blood pressure during pregnancy increases significantly if the mother was overweight before becoming pregnant, has had gestational hypertension with a previous pregnancy, or has an existing kidney dysfunction or diabetes. Gestational hypertension can also have an effect on blood supply to the baby.

Pre-Eclampsia: Pre-eclampsia is categorized as a blood pressure disorder and is marked by high blood pressure and excessive amounts of protein found in the urine. Pre-eclampsia can damage the blood vessels and can cause an insufficient blood flow to the uterus. The risk factor for developing this condition is highest during a first pregnancy or if there is a family history of pre-eclampsia. The only cure for pre-eclampsia is induced labor and delivery, usually by caesarean section (c-section).

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Umbilical Cord Compression: Because the fetus moves around so much inside the womb it is easy for the umbilical cord to become twisted, wrap around the baby’s neck, or become compressed. Compression of the cord can cause a lack of sufficient oxygen to the baby’s major organs. During labor the umbilical cord can stretch and become compressed causing a short decrease in blood flow but compression is extremely rare and measures can be taken to prevent it.

Weight Gain: Remember, you are now eating for two! Most expectant mothers will gain anywhere from 20 – 40 pounds during their pregnancy. If there is a low amount of weight gain during pregnancy your baby may not be getting all of the nutrients that he/she needs. If there is too much weight gain, on the other hand, this could lead to other problems not only for the baby but for the mother as well. One of the biggest concerns with being overweight during pregnancy is gestational diabetes.

Gestational Diabetes: Gestational diabetes occurs in women who have not previously been diagnosed with diabetes but show evidence of high blood glucose levels during their pregnancy. Women who have a family history of diabetes are at a higher risk for developing this condition. Some of the major potential dangers it poses for the baby include growth abnormalities, jaundice or yellowing of the skin and the whites of the eyes, an increased risk of difficulty with motor skill development such as walking and jumping, and chemical imbalances. Gestational diabetes is a condition that is reversible and a change in diet and adding an exercise regimen to your daily lifestyle can help to control blood glucose levels.

Fetal Movement: The first fetal movements are known as “quickening.” Most women will feel movement for the first time anywhere from 16 -22 weeks into their pregnancy. Expectant mothers have described “quickening” as a fluttering type sensation or “butterflies” in their tummy. Activity of the fetus is affected by the mother’s level of activity, sleeping habits, sound, and the time of day. Most obstetricians and gynecologists recommend that their patients keep a record of fetal activity beginning around week 28. A decrease in fetal movement could be an early warning sign of a problem. Women who present with a significant decrease in fetal movement are at a higher risk for stillbirth or pre-mature birth.

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Sources

Menihan, Cydney A. Electronic Fetal Monitoring: Concepts and Applications. USA: Lippincott Williams & Wilkins; Second Edition edit, 2007.

Maret, Stephen M. The Prenatal Person: Frank Lake’s Maternal-Fetal Distress Syndrome. Lanham, MD: UP of America, 2003.

Power, Michael L., and Jay Schulkin. Birth, Distress and Disease: Placental-Brain Interactions. New York: Cambridge University Press; 1 edition, 2005.

Goer, Henci. The Thinking Woman’s Guide to a Better Birth. USA: Perigee Trade; 1 edition, 1999.

Simkin, Penny. Pregnancy, Childbirth, and the Newborn: The Complete Guide. Minnetonka, MN: Meadowbrook; Revised Updated Edition, 2001.

Jovanovic-Peterson, Lois. Managing Your Gestational Diabetes: A Guide for You and Your Baby’s Good Health. USA: Wiley Publishing, 1994.

Gluckman, Peter, and Mark Hanson. The Fetal Matrix: Evolution, Development and Disease. New York: Cambridge UP; 1 edition, 2004.

Petrikovsky, Boris M. Fetal Disorders: Diagnosis and Management. USA: Wiley-Liss; 1 edition, 1999.

Sairam, Shanti, Basky Thilaganathan, and Aris T. Papageorgiu. Problem Based Obstetric Ultrasound (Series in Maternal Fetal Medicine). United Kingdom: Informa Healthcare; 1 edition, 2007.

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