When a pregnant mother feels like something is wrong, her instincts may be recognizing a problem with the fetus. Fetal distress is a general term for problems in the womb where the baby is at risk of injury, harm, or death. These problems can include oxygen deprivation, birth infection, or other birth complications. Fetal distress can have a number of causes and should be immediately evaluated by a doctor to reduce the risk of injury.
What is Fetal Distress?
Fetal distress is a general term that can include a number of pregnancy and birth complications. Doctors and nurses often avoid the term “fetal distress,” because it does not have a precise definition. Instead, medical personnel may refer to the specific signs and symptoms when there is a problem during pregnancy.
When a doctor or obstetrician recognizes distress in the fetus, the doctor may try to perform an emergency delivery by cesarean section, vaginal delivery, or through the use of forceps or a vacuum device. Emergency delivery may be the best option for treating a child who is suffering oxygen deprivation, circulatory system problems, or other distressing concerns for the baby’s health.
Some of the conditions that may be described as “fetal distress,” include:
- Decreased movement in the womb
- Increased or decreased fetal heart rate
- Irregular fetal heart rate
- Early labor pains
- Fetal metabolic acidosis
- Fetal lactic acidosis
- Meconium staining
- Breathing problems
The signs and symptoms the mother and baby are experiencing can help diagnose or identify the specific condition and evaluate the risk to the mother and baby. Diagnosing fetal problems may include diagnostic tests for the mother or fetus, including blood tests, cardiotocography, ultrasounds, or other imaging and lab tests.
Fetal Distress and Asphyxia
Fetal distress is commonly associated with birth asphyxia. Asphyxia is a lack of oxygen to the vital organs, including the heart and brain. When the fetus does not get enough oxygen, through a problem with the blood supply or oxygen supply, it can cause serious damage, including organ failure, brain damage, and death. The baby relies on the blood and oxygen supply from the mother through the umbilical cord. Problems with oxygen supply can be caused by:
- Low maternal blood pressure
- Blocked airway on delivery
- Nuchal umbilical cord
- Prolapsed umbilical cord
- Drug-induced hyperstimulation
- Placental separation
- Placenta previa
- Anesthesia errors
- Premature development
- Delayed C-section delivery
Lack of oxygen can be a cause for many birth complications, including hypoxic-ischemic encephalopathy (HIE). HIE is a brain injury caused by oxygen deprivation. Signs of possible oxygen deprivation that result in fetal distress include:
- Decreased fetal movement
- Severe maternal cramping and back pain
- Abnormal fetal heart rate
- Abnormal contractions
- Abnormal amniotic fluid levels
- Abnormally low or high maternal weight gain
- Maternal high blood pressure
- Maternal low blood pressure
- Vaginal bleeding
After the baby is born, the baby may exhibit signs and symptoms of hypoxia or anoxia that occurred in the womb or continue after delivery. Signs and symptoms of possible oxygen deprivation after delivery may include:
- Abnormal heart rate
- Meconium staining
- Low Apgar scores
- Feeding problems
- Breathing problems
- Poor muscle tone
- Organ failure
- Abnormal response to light
- Abnormal reflexes
- Hyperalertness or lethargy
It can be difficult to identify some signs of oxygen deprivation injuries after delivery. Minor brain damage may not be evident until the child gets older and begins missing developmental milestones. According to the Centers for Disease Control and Prevention (CDC), some of the first milestones occur by 2 months of age, including:
- Beginning to smile at people
- Trying to look at parents
- Cooing or making gurgling sounds
- Turns head toward sounds
- Pays attention to faces
- Follows things with eyes and recognize people at a distance
- Can hold head up and begins to push up when lying on tummy
- Makes smoother movements with arms and legs
The extent of oxygen deprivation is connected to the damage and consequences of hypoxia. If oxygen is restored quickly, it may result in no permanent damage. If oxygen levels are restored after being reduced or cut off, it can lead to mental disabilities or physical disabilities. If oxygen is not restored to the baby after a short period, it can cause cardiac arrest, organ failure, and brain death.
Fetal Distress and Birth Infection
Birth infections can also be a cause for fetal distress. Infections can occur in the womb prior to delivery. For example, chorioamnionitis is an infection of the placenta and amniotic fluid, which may occur if the amniotic sac is broken a long time before delivery.
Infections can also be passed from the mother to the baby through the umbilical cord and shared blood supply. Some infections that can be transmitted to a baby include:
- Cytomegalovirus (CMV)
Postmaturity and Fetal Distress
Postmaturity refers to babies who are born after a late-term pregnancy, at 42 weeks or later. Postmaturity delivery is not common with most doctors inducing labor in a late-term pregnancy. There may be a number of complications associated with postmaturity babies, including:
- Amniotic fluid problems (oligohydramnios)
- Decreased oxygen supply
- Meconium aspiration
- Persistent pulmonary hypertension
- Low blood sugar
Fetal Distress and Labor Complications
Labor complications may make delivery more difficult and require an emergency c-section. Delays in delivery or delays in performing a c-section can put the child at risk of oxygen deprivation, infection, or other birth injuries. Examples of labor complications that may cause “fetal distress,” include:
- Abnormal presentation
- Abnormal fetal positioning
- Shoulder dystocia
- Umbilical cord prolapse
- Nuchal cord
- Uterine rupture
Intubation and Anesthesia Problems and Fetal Distress
Intubation is the medical procedure to maintain an airway and access to the lungs, generally through inserting an endotracheal tube. Intubation is not common in pregnancy but may be required in a medical emergency or if the mother has to be placed on general anesthesia.
Problems with intubation or anesthesia which cause the mother to suffer oxygen deprivation can cause fetal distress. Anytime the mother is not getting enough oxygen, the lack of oxygen is also experienced by the baby. Without enough oxygenated blood flowing to the fetus through the umbilical cord and placenta, the baby may begin to suffer hypoxia, including cell damage and cell death.
Anesthesia drug interactions can also be a cause of fetal distress. If the mother or baby suffers a severe allergic reaction to drugs or anesthesia medication, it can cause anaphylaxis and reduce oxygen supply.
Diagnosing Fetal Distress
Fetal distress does not have a precise medical definition. When a fetus is having problems, the doctor may evaluate the mother or baby for a number of conditions. However, the most common complication associated with what people refer to as fetal distress is caused by oxygen deprivation.
Fetal distress may be evaluated by checking the baby’s heart rate and blood tests. Blood tests can show evidence of other distress causes, including fetal acidosis. Arterial blood gas tests can show the levels of oxygen and carbon dioxide in the blood and blood pH. Other diagnostic tests that evaluate fetal problems include checking kidney function, pH levels, proteins, blood sugars, electrolytes, and other chemicals.
Treating Fetal Distress
Treating fetal distress involves treating the specific condition affecting the baby. For example, if the mother is not getting enough oxygen, initial treatment may include supplemental oxygen and fluids. If there is a problem in the fetus, treatment often involves emergency delivery. An emergency c-section or instrumental delivery can deliver the baby to be treated directly through neonatal care. Neonatal care includes keeping a steady supply of oxygen and fluids, keeping the baby warm, and monitoring vital signs.
Medical Malpractice and Fetal Distress
When a baby is in distress or a mother expresses concerns about the well-being of the baby during pregnancy, doctors should evaluate the baby for possible signs of birth complications or other health conditions. Failure to properly monitor, evaluate, and treat fetal distress can increase the risk of serious injury or death.
Medical errors can put the baby and mother at risk. If a doctor, nurse, or hospital staff causes a birth injury, the parents may be able to hold the medical professionals accountable for their negligence.
A medical malpractice lawsuit can help parents recover damages to pay for the medical costs of raising a child with mental and physical disabilities caused by a birth injury. The lifetime costs of medical care and treatment for a birth injury can amount to a million dollars or more. Damages in a birth injury claim can help the parents pay for:
- Medical bills
- Future medical care
- Educational needs
- Home modifications
- Pain and suffering
Fetal Distress Birth Injury Malpractice Lawsuits
Fetal distress may be caused by a number of reasons, with oxygen deprivation among the most common causes of serious birth injury. Warning signs of possible perinatal asphyxia or hypoxia should be addressed immediately to reduce the risk of permanent damage. Failure to properly evaluate and diagnose birth complications may be medical malpractice.
If your child suffered a birth injury due to medical malpractice, talk to an experienced medical malpractice attorney about your options for recovery. Do not hesitate to contact Gilman & Bedigian today for a free consultation.