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Fetal Distress in Labor

Fetal Distress in Labour


Presentation

  • "— Presentation transcript: 1 Fetal Distress in labor Dr.Maysara Mohamed 2 What is fetal distress? Fetal distress is the term commonly used to describe fetal hypoxia.[slideplayer.com]
  • In breech presentation, meconium is passed in labour because of compression of the fetal abdomen during delivery. This is not a sign of distress unless it occurs in early labour. Top of page Clinical principles[hetv.org]
  • The plaintiff presented to the hospital in labor and underwent a full workup that did not reveal any abnormalities. Approximately 8 hours later, the baby's heart rate dropped severely.[mdmalpracticeattorney.com]
  • It is concluded that the admission test can detect fetal distress already present at admission and unnecessary delay in intervention can be avoided in such a case.[journals.lww.com]
  • […] the baby's head, neck and shoulders Umbilical cord prolapse (the cord preceding the baby) Nuchal cord (the umbilical cord becoming wrapped around the fetus's neck) Placental abruption (detached placenta) Uterine rupture (a tear in the uterus) Breech presentation[blockotoole.com]
Cerebral Palsy
  • If your child has been diagnosed with cerebral palsy, and you think it may be due to a lack of oxygen during labor, you may want to speak with an experienced birth injury lawyer or cerebral palsy law firm for more information.[klinespecter.com]
  • Becker Read more less 14.5 Million Cerebral Palsy Jones vs.[ohio-birthinjurylawyers.com]
  • Intrapartum hypoxia is thought to be the leading cause of cerebral palsy 3 risk factors Diabetes Hypertensive disorders in pregnancy Maternal infection haemoglobinopathy Chronic substance abuse Post-term multiple pregnancy IUGR Prolonged labor Uterine[slideplayer.com]
  • If fetal distress is not diagnosed and promptly treated, it could lead to permanent brain damage, cerebral palsy or a still born birth.[beasleyfirm.com]
Death in Infancy
  • Confidential Enquiry into Stillbirths and Deaths in Infancy . 4th Annual Report . London : Maternal and Child Health Research Consortium ; 1997 . 21. Fletcher , G , Flin , R , McGeorge , P , et al .[cambridge.org]
  • Confidential report on stillbirths & deaths in infancy. 7th Annual report. Maternal & Child Health Consortium. London 2000[ispub.com]
HELLP Syndrome
  • Becker Read more less 2 Million Maternal Wrongful Death Wrongful death action against obstetrician and hospital based on a failure to timely diagnose and treat pre-eclampsia in a 29-year-old woman leading to HELLP syndrome and fatal DIC (disseminated[ohio-birthinjurylawyers.com]
Overeating
  • By 8:20 A.M., the FHR was now over 200 bpm; and, the fetal head was at a 2 station. The OB decided to have the mother push in an effort to deliver the fetus vaginally. At 9:30 A.M., the OB decided to do a vacuum delivery.[europeanmedical.info]
  • Call today for a free consultation all over the state of Kansas. We have proudly served clients in Sedgwick, Butler, Sumner, Harvey, Kingman and Reno Counties.[kansaslaw.com]
  • In total, we have recovered well over 1 billion* on behalf of clients statewide. What Is Fetal Distress? A wide variety of health problems can cause symptoms that fall under the umbrella term of fetal distress.[blockotoole.com]
  • The obstetrical nurse mismanaged the induction over a 10 to 12 hour time period which resulted in severe asphyxia and permanent brain injury. Sara went on to sustain profound cerebral palsy and severe development delays. Michael F.[ohio-birthinjurylawyers.com]
  • However, prolonged severe variable decelerations are like the swimmer who is not coming up for air often enough……over a period of time, there is some oxygen deprivation.[pregnancycrawler.com]
Photophobia
  • The most common side effects are: Headaches and dizziness Flushing or a rash Nausea and upset stomach Photophobia (sensitivity to light) Stuffy or runny nose Back or muscle pain More serious, although less common, complications are: Heart attack Sudden[bellybelly.com.au]
Reduced Fetal Movement
  • Signs and symptoms of fetal distress include: Reduced fetal movement or lack of movement altogether Meconium (fetal feces) in amniotic fluid Decreased heart rate A significant increase in heart rate Lack in response to stimuli Cramping Many of these symptoms[birthinjuryinfo.org]
  • Signs and Symptoms of Fetal distress: Either in pregnancy, which would be picked up through reduced fetal movements (kicks) Or in labour, when it would usually be detected through changes to the baby’s heart rate.[kiwifamilies.co.nz]
  • Reduced fetal movements. Royal College of Obstetricians and Gynaecologists, Green-top guideline, 57. RCOG. 2012. Information for you: your baby's movements in pregnancy. Royal College of Obstetricians and Gynaecologists. Tidy C. 2013.[babycenter.in]
  • Reduced fetal movements. Royal College of Obstetricians and Gynaecologists, Green-top guideline, 57. www.rcog.org.uk [Accessed March 2016] RCOG 2011. www.rcog.org.uk RCOG. 2012. Information for you: your baby's movements in pregnancy.[babycentre.co.uk]
Fetal Disorder
  • Secondly, various fetal disorders, congenital diseases and fetal cardiac failure will develop fetal hypotension reducing fetal placental circulation and oxygen intake. Therefore, the treatment of fetal disorders will improve fetal hypoxia.[oatext.com]
Foul Smelling Vaginal Discharge
  • vaginal discharge) give antibiotics as for amnionitis ; - If the cord is below the presenting part or in the vagina, manage as prolapsed cord.[hetv.org]
Neonatal Seizures
  • The infant may suffer: Hypoxic ischemic encephalopathy Meconium aspiration syndrome Cerebral palsy Neonatal seizures 8 Intrapartum Testing Tests utilized to assess fetal well being during labor include: Intermittent auscultation of the fetal heart rate[slideplayer.com]
  • Fetal and neonatal outcomes Perinatal hypoxia-ischaemia: Evidence on Apgar scores less than 7 at 5 minutes, neonatal seizures and hypoxic-ischaemic encephalopathy (HIE) is of very low certainty.[extranet.who.int]
Spastic Quadriplegia
  • Subsequently, the infant was delivered and later noted to be permanently neurologically impaired with spastic quadriplegia. Maternal seizures are a well-known but infrequent sequel of pre-eclampsia.[europeanmedical.info]
  • The lack of oxygen resulted in a diagnosis of spastic quadriplegia cerebral palsy, the most severe case of CP, seizure complications, microcephaly, and developmental delays.[beamlegalteam.com]
Quadriplegia
  • Subsequently, the infant was delivered and later noted to be permanently neurologically impaired with spastic quadriplegia. Maternal seizures are a well-known but infrequent sequel of pre-eclampsia.[europeanmedical.info]
  • The lack of oxygen resulted in a diagnosis of spastic quadriplegia cerebral palsy, the most severe case of CP, seizure complications, microcephaly, and developmental delays.[beamlegalteam.com]
Neonatal Seizures
  • The infant may suffer: Hypoxic ischemic encephalopathy Meconium aspiration syndrome Cerebral palsy Neonatal seizures 8 Intrapartum Testing Tests utilized to assess fetal well being during labor include: Intermittent auscultation of the fetal heart rate[slideplayer.com]
  • Fetal and neonatal outcomes Perinatal hypoxia-ischaemia: Evidence on Apgar scores less than 7 at 5 minutes, neonatal seizures and hypoxic-ischaemic encephalopathy (HIE) is of very low certainty.[extranet.who.int]
Meningism
  • The obstetrical caregivers negligently failed to provide intra-partum and immediate post-partum antibiotics to Jennifer who ultimately developed severe meningitis. Jennifer went on to sustain profound cerebral palsy and developmental delays.[ohio-birthinjurylawyers.com]

Workup

  • The plaintiff presented to the hospital in labor and underwent a full workup that did not reveal any abnormalities. Approximately 8 hours later, the baby's heart rate dropped severely.[mdmalpracticeattorney.com]

Treatment

  • If these techniques don't work, the best treatment is a quick delivery (most often by C-section — unless a vaginal birth is imminent). From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting.[whattoexpect.com]
  • Management / Treatment of Fetal Distress The immediate aim of treatment is to increase oxygen supply to the fetus. This is done by: Ensuring that the mother has adequate oxygen, preferably with an oxygen mask.[gynaeonline.com]
  • If you have had a Kansas medical malpractice injury that was not your fault and need medical treatment, you need an experienced professional who can help you get back on the road to recovery.[kansaslaw.com]
  • Prompt and effective treatment can often reverse the effects of distress. Mothers with preexisting conditions and/or high-risk pregnancies will be monitored extra carefully, but all fetuses and mothers should be watched closely for complications.[marylandmalpracticecenter.com]
  • Unreassuring fetal monitor strips that show decelerations in the heart rate, tachycardia (fast heart rate), bradycardia (low heart rate) or a loss of variability may require the following treatments: Administer oxygen to the mother Turn the mother onto[beasleyfirm.com]

Prognosis

  • If they have delayed too long, even by a second, it can change your child’s lifelong prognosis. Electronic Fetal Monitoring (EFM) One of the most reliable and common methods of verifying fetal health is electronic fetal monitoring (EFM).[bluegrassjustice.com]
  • Furthermore, the improvement of prognosis for postdate pregnancy is due to the availability of electronic fetal monitoring and ultrasound, making possible the identification of fetal distress , as well as the use of prostaglandin to ripen a stubborn cervix[wikigenes.org]
  • Classification and prognosis of fetal heart rate patterns. Am J Obstet Gynecol. 1979;133:762–72. 22. Paul RH, Suidan AK, Yeh S, Schifrin BS, Hon EH. Clinical fetal monitoring. VII.[aafp.org]

Etiology

  • The etiology is unknown, but a subclinical fetal hypoxia might have triggered a vasodilation of placental vessels. Vasodilation at an unchanged volume flow could also explain the decrease of umbilical venous flow velocity.[ncbi.nlm.nih.gov]
  • Induction of labor and intrapartum fetal distress Last Updated on Thu, 14 Apr 2016 Etiology Many cases also arose in the context of induction of labor for pre-eclampsia with the subsequent development of intrapartum ''fetal distress.''[europeanmedical.info]

Epidemiology

  • References: Fetal Distress: Diagnosis, Conditions & Treatment at Fetal Distress – Pathogenesis, Epidemiology, Presentation, Investigations, Management at Hofmeyr GJ, Lawrie TA (2012 Jan 18) Amnioinfusion for potential or suspected umbilical cord compression[medicalfoxx.com]
  • PAUL SABIN 2008 STUDIU CLINICO-EPIDEMIOLOGIC, HISTOLOGIC ŞI IMUNOHISTOICHIMIC AL ADENOCARCINOAMELOR DE POL GASTRIC SUPERIOR Prof.univ.dr FLORIN BOGDAN MENEGOS VASILIOS 2008 IMPLICAŢIILE INFECŢIEI CERVICO-VAGINALE ÎN NEOPLAZIA COLULUI UTERIN Prof.univ.dr[umfcv.ro]
  • Epidemiology The overall risk of prompt caesarean delivery needed for fetal concern was shown to be 3.1% in an unselected population [ 1 ].[patient.info]
  • , Amsterdam, 1007 MB, the Netherlands (2) Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands (3) Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands (4) Department of Epidemiology[bmcpregnancychildbirth.biomedcentral.com]
  • Validity of the technique ie. an epidemiologic study of the frequency of the different FHR patterns correlated with characteristics of the mother and infant.[ispub.com]
Sex distribution
Age distribution

Pathophysiology

  • […] haemoglobinopathy Chronic substance abuse Post-term multiple pregnancy IUGR Prolonged labor Uterine hyperstimulation,precipitate labor 4 Cord prolapse Placental abruptio Maternal pyrexia Chorioamnionitis Meconium Antenatal & intrapartum haemorrhge 5 Pathophysiology[slideplayer.com]
  • References Maeda K, Kimura S, Nakano H, Fukui Y, Ozawa S, et al. (1969) Pathophysiology of Fetus. Fukuoka Printing, Proc, 21st JSOG Conv, Shukudai lecture.[oatext.com]
  • Cesarean delivery in relation to birthweight and gestational glucose tolerance: pathophysiology or practice style? JAMA. 1996;275:1165–70. View Article PubMed Google Scholar Lai FY, Johnson JA, Dover D, Kaul P.[bmcpregnancychildbirth.biomedcentral.com]
  • Pathophysiology of intrauterine asphyxia The dependence of the fetus on the mother for exchange of oxygen and carbon dioxide is reliant on adequate maternal blood gas concentrations, uterine blood supply, placental transfer and fetal gas transport.[ispub.com]

Prevention

  • Preventing Fetal Distress A doctor should recognize risk factors of fetal distress and take appropriate measures to prevent it.[birthinjuryinfo.org]
  • Preventing fetal distress Although there is no way to completely prevent every form of fetal distress, there are certain measures that can be taken by mothers and medical practitioners that reduce the likelihood of it from occurring, such as: Eating right[thecplawyer.com]
  • CONCLUSION: An antepartum fetal surveillance program using twice-weekly nonstress test and fluid index assessment in pregnancies complicated by diabetes was successful in preventing stillbirth.[ncbi.nlm.nih.gov]
  • […] as the following can lead to birth injuries like cerebral palsy : Fetal metabolic acidosis Increased or decreased fetal heart rate Meconium in the amniotic fluid Poor vital signs that may indicate hypoxia Today’s modern hospitals are well equipped to prevent[njadvocates.com]
  • Thick meconium suggests passage of meconium in reduced amniotic fluid and may indicate the need for expedited delivery and meconium management of the neonatal upper airway at birth to prevent meconium aspiration (page S-143).[hetv.org]

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