What are the signs of fetal distress?

Ask Us Any Birth Injury Question? Find out if you have a case.

Breathing problems

When a baby does not start to breathe at birth, even though no problems were detected before delivery, the baby will require resuscitation. This is why a skilled obstetric team is a necessity for any birthing environment or complicated vaginal delivery.

Abnormal position and presentation of the fetus or stuck in the birth canal

Position refers to whether the fetus is facing rearward (toward the woman's back, or face down) or forward (face up). Presentation refers to the part of the fetus's body that leads the way out through the birth canal. The most common and safest combination is head first and facing down, with the face and body angled toward the right or left and with the neck bent forward, chin tucked in, and arms folded across the chest. If the fetus is in a different position or presentation, labor may be more difficult and delivery through the vagina may not be possible.

Multiple births

The number of twin, triplet, and other multiple births has been increasing over the past 20 years. During pregnancy, the number of fetuses can be confirmed by ultrasonography. Carrying more than one fetus overstretches the uterus. An overstretched uterus tends to start contracting before the pregnancy reaches full term causing babies to be born prematurely and to have a low birth weight.

Get More Information Now!

In some cases, the overstretched uterus does not contract well after delivery, causing the mother to bleed after delivery. Because the fetuses can be in various positions and presentations, vaginal delivery can be complicated. Also, the contraction of the uterus after delivery of the first baby may shear away the placenta of the remaining baby or babies. As a result, the baby or babies that follow the first may have more problems during delivery and later.

For these stressful reasons, doctors may decide in advance how to deliver twins -- vaginally or by cesarean section. Occasionally, the first twin is delivered vaginally, but a cesarean section is considered safer for the second twin. For triplets and other multiple births, doctors usually perform a cesarean section.

Shoulder dystocia

Shoulder dystocia occurs when one shoulder of the fetus lodges against the woman's pubic bone and the baby becomes caught in the birth canal. The head comes out, but it is pulled back tightly against the vaginal opening. The baby cannot breathe because the chest is compressed by the birth canal. As a result, oxygen levels in the baby's blood decrease. This complication is more common with large fetuses, particularly when labor has been difficult or when forceps or a vacuum extractor has been used because the fetus's head has not fully descended in the pelvis.

When this complication occurs, the doctor quickly tries various techniques to free the shoulder so that the baby can be delivered vaginally. In extreme circumstances, if the techniques are unsuccessful, the baby may be pushed back into the vagina and delivered by cesarean section.

Contact a Lawyer!

Prolapsed umbilical cord

The umbilical cord precedes the baby through the vagina in about 1 of 1,000 deliveries. When the umbilical cord prolapses, it may constrict so that the fetus' blood supply is cut off. This complication may be overt or not. Prolapse is overt when the membranes have ruptured and the umbilical cord protrudes into or out of the vagina before the baby emerges. Overt prolapse usually occurs when a baby emerges buttocks first (breech presentation). But it can occur when the baby emerges head first, particularly if the membranes rupture prematurely or the fetus has not descended into the woman's pelvis. If the fetus has not descended, the rush of fluid as the membranes rupture can carry the cord out ahead of the fetus. If the cord prolapses, immediate delivery, almost always by cesarean section, is necessary to prevent the blood supply to the fetus from being cut off. Until surgery begins, a nurse or doctor holds the fetus’ body away from the cord so that the blood supply through the prolapsed cord is not cut off.

When the prolapsed is not overt or obvious, the opposite is considered occult. Membranes are intact and the cord is in front of the fetus or trapped in front of the fetus' shoulder. Usually, an occult prolapse can be identified by an abnormal pattern in the fetus heart rate. Changing the woman's position or raising the fetus head to relieve pressure on the cord usually corrects the problem. Occasionally, a cesarean section is necessary.

Nuchal cord

The umbilical cord is wrapped around the fetus' neck in about 25 percent of deliveries. Normally, the baby is not harmed. Before birth, a nuchal cord can sometimes be detected by ultrasonography, but no action is required. Doctors routinely check for it as they deliver the baby. If they feel it, they can slip the cord over the baby's head.

Placental abruption

If the placenta separates from the inner wall of the uterus before delivery, it's known as placental abruption. Placenta abruption is a rare but serious complication requiring immediate medical attention. The uterus bleeds from the site where the placenta was attached. The blood typically passes through the cervix and out the vagina. Sometimes, the blood remains trapped behind the placenta. Left untreated, placental abruption puts both mother and baby in danger.

Meconium

Meconium staining of amniotic fluid is seen frequently as the fetus matures and by itself is not an indicator of fetal distress. A slight degree of meconium without fetal heart rate abnormalities is a warning of the need for vigilance. 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 Syndrome (MAS). In breech presentation, meconium is passed in labor because of compression of the fetal abdomen during delivery. This is not a sign of distress unless it occurs in early labor.

Fetal macrosomia

Fetal macrosomia (excessive birth rate / 8 pounds 14 oz) and complications associated with macrosomia risk of cesarean delivery, postpartum hemorrhage, vaginal lacerations, urinary tract infection, shoulder dystocia, fracture of the clavicle, and brachial plexus injury.

C-Sections

A C-section is the surgical delivery of a baby that involves making incisions in the mother's abdominal wall and uterus. Generally considered safe, C-sections do have more risks than vaginal births. There's far less chance of infection and severe bleeding with a vaginal delivery than with a C-section. Plus, you can come home sooner and recover quicker after a vaginal delivery. C-sections are worth avoiding, if possible. However, these common surgical deliveries can help women with high-risk pregnancies avoid dangerous delivery-room complications and can save the life of the mother and/or baby in emergency situations.

Has your newborn suffered a fetal distress? Don’t hesitate to contact a Pennsylvania law firm specializing in birth injuries. Contact Anapol Schwartz. This is a difficult time; let us help.

Please fill out the form below to see if you have a Birth Injury case.

* Click on the Disclaimer, below, for Terms MALPRACTICE INFORMATION
Date of Birth:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902
Date of Injury:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902
Name of Facility (Hospital/Doctor):
Please Describe What Happened:
HOW MAY WE CONTACT YOU?
First Name:
Last Name:
Address:
City:
Zipcode:
Phone #1:	() - ext.
Phone #2:	() - ext.
E-mail Address: