Fetal Distress Dr SimonByonanuwe
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Feta Distress is a condition that describes inadequate oxygen delivery to the fetus during pregnancy or labor with resultant fetal hypoxia, abnormal fetal heart patterns and acidosis. It is one of the most common life threatening fetal conditions in the field of obstetrics with associated high fetal morbidity and mortality. Understanding the basics of this condition, including the pathogenesis and management by the maternal and child health care providers is therefore crucial towards reducing the associated short and long term sequelae of fetal distress. This power point is a key stimulant to Medical students and Doctors involved in providing maternal and child health care to further reading and understanding about fetal distress.
Fetal Distress Dr SimonByonanuwe
- 1. FETAL DISTRESSFETAL DISTRESS Dr Simon Byonanuwe OBGYN
- 2. INTRODUCTIONINTRODUCTION Condn that describes inadequate O2 delivery to fetus during preg or labor tht results into; 端Fetal hypoxia 端Abn FHR patterns 端Acidosis 10/21/2019 DR SIMON BYONANUWE
- 3. ContCont Fetal O2 distrbutn depends on; 端O2 delivery from maternal lungs Uterus+Placenta. 端Diffusion from placenta Fetal blood. 端Distribn of fetal O2 bld Various fetal tissues O2 from above 3 steps result in fetal distress. Uterine contractns durg laborutero placentl bld flowO2 delivery to fetus 10/21/2019 DR SIMON BYONANUWE
- 4. PATHOPHYSIOLOGYPATHOPHYSIOLOGY Adequate O2 supply Aerobic glycolysis occurs Glycogen Pyruvic acid(PA) PA is then oxidised via Krebs cycle. 10/21/2019 DR SIMON BYONANUWE
- 5. Hypoxia Anaerobic Glycolysis Lactic acid + Pyruvic acid Metabolic acidosis H 10/21/2019 DR SIMON BYONANUWE
- 6. CONSEQUENCESCONSEQUENCES 1. Stimulation and depressn of SAN: vTachycardia vBradycardia 2. PSN stimulation Hyperperistalsis and relaxn of anal sphincter Passage of meconeum 10/21/2019 DR SIMON BYONANUWE
- 7. ContCont Summary; Oxygenation Hypoxia Metabolic acidosis NR fetal status Asphyxia Tissue Damage / Fetal death. 10/21/2019 DR SIMON BYONANUWE
- 9. AFDAFD vUterine rupture vPlacenta abruptio vCord prolapse vInjudicious admin of analgesics and anesthesia vMaternal hypotension vUterine hyperstimulatn 10/21/2019 DR SIMON BYONANUWE
- 10. CFDCFD Causes are condns responsible for chronic placental insufficiency and IUGR Include: vAnemia vHTN vThrombotic dse vCardiac dse vPlacental infarction. 10/21/2019 DR SIMON BYONANUWE
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- 12. REVERSIBLEVs IRREVERSIBLEREVERSIBLEVs IRREVERSIBLE FACTORS ASSOCIATDWTH F/DFACTORS ASSOCIATDWTH F/D 1. Transient factors (Reversible) Labor can ctn aftr correctn of cause, with close monitoring vsed uterine activity vPoor maternal posn vMaternal hypotension 10/21/2019 DR SIMON BYONANUWE
- 13. ContCont 2. Permanent factors (Irreversible) vFetus has to b delivred immediately after IUFR. vInclude; qPlacental abruption qMaternal or fetal haemorrhage qUterine rupture qCord prolapse 10/21/2019 DR SIMON BYONANUWE
- 14. ContCont Unfortunately, FHR monitoring cannot reliably distinguish btn these 2 situations The clinical situation has to be reviewed continuosly and carefully aftr deterioration in the FHR pattern 10/21/2019 DR SIMON BYONANUWE
- 15. RISK FACTORSRISK FACTORS 端Anemia 端HTN 端DM 端Maternal infection 端Asthma 端Post term pregnancies 10/21/2019 DR SIMON BYONANUWE
- 16. ContCont 端Labor induction/augmentation 端Supine posn 端Cord abn/accidents 端Fetal anemia 端Vasaprevia, Fetal-placental hemorrhage, Hymolytic dse 端Prematurity 端E.t.c 10/21/2019 DR SIMON BYONANUWE
- 17. 1. Abn FHR patterns 2. Presence of meconeum 3. Fetal pH DXDX 10/21/2019 DR SIMON BYONANUWE
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- 19. ContCont 端>7.25Observn of labor 端7.20 7.25Repeat 30mins later 端<7.20Repeat immediately, if confirmed: immediate delivery. 10/21/2019 DR SIMON BYONANUWE
- 20. MGTMGT 1. IUFR 2. Correct any fetal insult 3. Deliver 10/21/2019 DR SIMON BYONANUWE
- 21. ALGORITHM FOR MGT OF ABNALGORITHM FOR MGT OF ABN HEARTTRACING DURING FETALHEARTTRACING DURING FETAL MONITORINGMONITORING 10/21/2019 DR SIMON BYONANUWE
- 22. COMPLICATIONSCOMPLICATIONS Low Apgar scores HIE Infections Neonatal mortality and morbidity Maternal mortality and morbidity 10/21/2019 DR SIMON BYONANUWE
- 23. THANKYOU 10/21/2019 DR SIMON BYONANUWE