Fetal distress is the presence of signs in a pregnant woman, before or during childbirth, suggesting the fetus may not be well. Because it lacks precision, current recommendations suggest to replace the term with more specific Sx.

The constellation of Sx that fetal distress involves, includes:

• Decreased fetal movement felt by the mother
• Meconium stained liquor [due to meconium in the amniotic fluid]
• Non-reassuring CTG, including:
  • Increased/decreased FHR (tachycardia, bradycardia), especially during or after a contraction
  • Decreased variability in the FHR
  • Late decelerations
• Biochemical signs, gathered from a small sample of a baby's blood from a scalp prick through the open cervix in labor:
  • Fetal metabolic acidosis
  • Elevated fetal blood lactate levels [from fetal scalp blood testing] indicating the fetus has lactic acidosis

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 (i.e. liver disorder during pregnancy)

• Traditionally, Dx of fetal distress led the obstetrician led to rapid delivery by instrumentation, or by C section if vaginal delivery was not advised. It is now recommended specific Sx be addressed