Foetal Distress

Question 1

Foetal distress maternal risk factors

Answer 1

Obesity
Old maternal age >35
chronic disease
Preeclampsia / GHTN
Smoking
Anaemia

Question 2

Foetal distress maternal risk factors

Answer 2

Fetal growth restriction (FGR/IUGR)

Abnormal fetal position (malpresentation, mispositioning)

Congenital anomalies

Decreased fetal movements

Question 3

Foetal distress Intrapartum/Labour Factors

Answer 3

Prolonged or rapid labor

Strong or frequent uterine contractions

Use or misuse of medical tools (forceps, vacuum)

Intrauterine infection/chorioamnionitis

Abnormal fetal heart rate tracing

Reduced uterine perfusion/hypovolaemia

Question 4

Define Foetal distress

Answer 4

occurs when the fetus does not receive adequate oxygen

Question 5

Foetal distress clinical signs

Answer 5

1. Fetal Heart Rate Abnormalities (CTG Monitoring): Tachycardia (>160), Bradycardia (< 110)
2. Fetal Movement Changes
   Decreased or absent fetal movements reported by the mother.
3. Meconium-Stained Amniotic Fluid
   Presence of significant meconium in the amniotic fluid during labour

Question 5

Foetal distress assessment

Answer 5

Continuous electronic fetal monitoring (CTG)

Maternal assessment: Vitals, uterine activity, infection screen

Physical examination: Abdominal palpation, vaginal examination if indicated

Ultrasound: Fetal biometry, amniotic fluid index, Doppler studies

Fetal blood sampling (if available and indicated): Assess fetal acid-base status (pH, lactate)

Question 6

Foetal distress Mx

Answer 6

Initial measures:
Position mother in left lateral position
Stop oxytocin/uterotonic drugs if being administered
Correct maternal hypotension (IV fluids, treat underlying cause)
Administer oxygen if maternal hypoxia
Treat maternal pyrexia/infection (antibiotics if indicated)
Intrauterine resuscitation:
Reduce uterine contractions (tocolysis if hyperstimulation)
Amnioinfusion (in cases of variable decelerations with oligohydramnios)
Escalation:
Urgent obstetric review
Expedited delivery