Fetal distressLIN QI DE 2005.9.5

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Fetal distress is defined as depletion of oxygen and accumulation of carbon dioxide,leading to a state of hypoxia and acidosis during intra-uterine life. Definition

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Maternal factorsMicrovascular ischaemia(PIH)Low oxygen carried by RBC(severe anemia)Acute bleeding(placenta previa, placental abruption) Shock and acute infectionobstructed of Utero-placental blood flow Etiology

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Placentaumbilical factors

Obstructed of umbilical blood flowDysfunction of placentaFetal factorsMalformations of cardiovascular systemIntrauterine infection Etiology

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Hypoxiaaccumulation of carbon dioxide Respiratory AcidosisFHR FHR FHR Intestinal peristalsisRelaxation of the anal sphincterMeconium aspirationFetal or neonatal pneumoniaPathogenesisAcute fetal distress

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ChronicFetaldistressPathogenesis IUGR(intrauterine growth retardation)

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Clinical manifestationAcute fetal distress

(1)FHR FHR>180 beats/min (tachycardia)

FHR:120~160 bpm / FHR variability

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Early decelerationED

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Late decelerationLD

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Variable decelerationVD

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Clinical manifestationAcute fetal distress

(2) Meconium staining of the amniotic fluid grade IIIIII (3) Fetal movement Frequentlydecrease and weaken (4) Acidosis FBS (fetal blood sample) pH

Clinical manifestationChronic fetal distress

(1) Placental function (24h E3

ManagementRemove the induced factors activelyCorrect the acidosis: 5%NaHCO3 250MLTerminate the pregnancy (1) FHR>160 or

ManagementTerminate the pregnancy (4) Repeated LD and severe VD (5) Baseline variability disappear with LD (6) FBS pH

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