Fetal Distress and DFM
Fetal Distress and DFM
Fetal Distress and DFM
Song weiwei
[email protected]
Cell phone:13591441088
Pathophysiology
Hypoxia!
Acidosis----sympathetic nerve excited--- hypertension,
tachycardia (initial signs)
chronic condition:
nutritional deficiency----FGR
Treatment
Mothers condition must be treated to prevent
hypoxia to the fetus including:
Blood pressure stabilization
Maternal positioning on the left side
Monitoring maternal oxygenation
Pelvic exam to identify cord presentation
Treatment
Oxygen administration to the mother may provide
additional availability of oxygen to the fetus.
Trained neonatal resuscitation staff should be
available at all times and should be present in the
delivery suite for those patients with known risk
for fetal distress or hypoxia.
Cesarean sections are performed if all else fails,
and are the last alternative when faced with the
possibility of fetal distress.
Evaluation
Nonstress test/cardiotocography: Provides immediate
reassurance of fetal viability and well-being
Ultrasound: Valuable assessment tool, of pregnancies
complicated by persistent DFM despite a reactive NST.
Doppler velocimetry: Useful if fetal growth restriction has
been identified on ultrasound examination
Testing for fetomaternal transfusion A maternal assay
(Kleihauer-Betke stain or flow cytometry) to detect
fetomaternal hemorrhage should be performed in the evaluation
of the pregnant patient who presents with DFM and a
sinusoidal fetal heart rate pattern, unexplained fetal
tachycardia, or fetal hydrops on ultrasound associated with
elevated middle cerebral artery Doppler velocity.
Thank you