Fetal distress refers to the presence of signs in a pregnant woman—before or during childbirth—that suggest that the fetus may not be well. Because of its lack of precision, the term is eschewed in modern American obstetrics.
Signs and symptoms
Generally it is preferable to describe specific signs in lieu of declaring fetal distress that include:
- Decreased movement felt by the mother
- Meconium in the amniotic fluid ("meconium stained fluid")
- Non-reassuring patterns seen on cardiotocography:
- Biochemical signs, assessed by collecting a small sample of baby's blood from a scalp prick through the open cervix in labor
Some of these signs are more reliable predictors of fetal compromise than others. For example, cardiotocography can give high false positive rates, even when interpreted by highly experienced medical personnel. Metabolic acidosis is a more reliable predictor, but is not always available.
There are many causes of "fetal distress" including:
- Breathing problems
- Abnormal position and presentation of the fetus
- Multiple births
- Shoulder dystocia
- Umbilical cord prolapse
- Nuchal cord
- Placental abruption
- Premature closure of the fetal ductus arteriosus
- Uterine rupture
- Intrahepatic cholestasis of pregnancy, a liver disorder during pregnancy
- Maternal diabetes (Type 1 or 2) or gestational diabetes (GDM)
Instead of referring to "fetal distress", current recommendations hold to look for more specific signs and symptoms, assess them, and take the appropriate steps to remedy the situation  through the implementation of intrauterine resuscitation. Traditionally the diagnosis of "fetal distress" led the obstetrician to recommend rapid delivery by instrumental delivery or by caesarean section if vaginal delivery is not advised.
- Fetal+Distress at the US National Library of Medicine Medical Subject Headings (MeSH)
- "Fetal Distress". American Pregnancy Association. August 2015. Retrieved March 1, 2018.
- Tarvonen M, Hovi P, Sainio S, Vuorela P, Andersson S, Teramo K (2021). "Intrapartal cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus". Acta Diabetologica.CS1 maint: multiple names: authors list (link)
- Simpson PhD, RNC, Kathleen Rice; Garite MD, Thomas (March 2011). "Intrauterine Resuscitation During Labor". Clinical Obstetrics and Gynecology. 54 (1): 28–39. doi:10.1097/GRF.0b013e31820a062b. PMID 21278499.