Fetal Heart Rate Monitoring and Fetal Distress

Fetal heart rate monitoring is performed to monitor fetal distress. It lets a medical professional monitor a baby's heartbeat in the uterus, including during labor. During contractions, blood vessels in the uterus constrict, or narrow, and briefly reduce the supply of oxygen going to the baby. When the baby's blood supply is reduced, it is called ischemia. When the contraction finishes, the blood vessels reopen, and the blood returns. Fetal heart rate normally changes as a result of changes in the supply of oxygen, however, some changes may signal that the baby is not getting enough oxygen. When the amount of oxygen in the blood decreases, it is called hypoxia. Although there is no clear definition for the term "fetal distress," a change in the heart rate signaling that there is not enough oxygen is a sign that the baby is having trouble, or that is, experiencing fetal distress. A baby will be considered safe as long as the heart rate stays below 160 and above 100-120, and it does not become irregular. So, by monitoring, if certain changes are detected, steps can be taken to treat the underlying problem. A normal heart rate during monitoring can also assure everyone that it is safe to keep moving forward with the labor if there are no other problems. There is no way of knowing if a baby is suffering fetal distress unless the fetal heart rate is being monitored. Not monitoring runs a higher risk of permanent damage being suffered during labor. 

Fetal distress is also known as "nonreassuring fetal heart tracing" and is characterized most commonly during labor when the baby's heartbeat becomes flat or drops to a lower level repeatedly, which is an indication of stress on the baby. Three types of heart decelerations are as follows:

  • Early heart deceleration usually means there is head compression; it is the most common.
  • Variable heart deceleration usually means cord compression; it is normally seen during labor when the mother is pushing.
  • Late heart deceleration is cause for the most concern; though a single deceleration may not be so bad, persistent late decelerations are normally followed by concern for the baby's well-being.

Fetal heart monitoring can help detect fetal distress conditions during pregnancy such as:

  • The umbilical cord is looped around the baby's neck.
  • Uterine infection.
  • Uterine rupture.
  • Separation of the placenta from the wall of the uterus (placental abruption).
  • Reduced blood flow to the baby (cord compression).
  • Electrical signals being blocked within the heart muscle and causing an altered heartbeat (fetal heart block).
  • Incorrect positioning of the baby (fetal malposition).
  • Too little oxygen supply to the baby (potential fetal hypoxia).
  • Too little oxygen exchange between the uterus and the placenta (uteroplacental insufficiency).
  • Severe anemia in the baby.

Negative long-term effects of fetal distress may include:

  • Autism
  • Brain injury
  • Cerebral palsy
  • Cortical blindness
  • Delays in development
  • Mental retardation
  • Stillbirth

To avoid birth injury due to fetal distress, the doctor needs to monitor the delivery process. Fetal heart monitoring is a part of this. In cases of difficult labor, induced labor, or post-term, monitoring is especially critical because of an increased risk of fetal distress. Medical professionals need to respond appropriately to signs of fetal distress including:

  • Fetal heart rate monitoring should be done.
  • Medical staff should be trained to read and interpret fetal heart rate monitoring (FHM) strips.
  • The doctor should be present and informed of fetal distress.
  • The doctor, if appropriate, should deliver the baby by c-section.

If you feel that you or a loved one has been harmed due to negligence or malpractice related to fetal heart rate monitoring and fetal distress, please contact the lawyers at Sweeney Law Firm to find out your legal rights. Sweeney Law Firm offers free consultations and there is never a fee unless we obtain a financial recovery in your legal case.