Managing Complications in Pregnancy and Childbirth: - IAWG

FETAL DISTRESS IN LABOUR S-95PROBLEMS• Abnormal fetal heart rate (less than 100 or more than 180 beats perminute).• Thick meconium-stained amniotic fluid.GENERAL MANAGEMENT• Prop up the woman or place her on her left side.• Stop oxytocin if it is being administered.ABNORMAL FETAL HEART RATEBOX S-7Abnormal fetal heart rate• A normal fetal heart rate may slow during a contraction but usuallyrecovers to normal as soon as the uterus relaxes.• A very slow fetal heart rate in the absence of contractions orpersisting after contractions is suggestive of fetal distress.• A rapid fetal heart rate may be a response to maternal fever, drugscausing rapid maternal heart rate (e.g. tocolytic drugs), hypertensionor amnionitis. In the absence of a rapid maternal heart rate, a rapid fetalheart rate should be considered a sign of fetal distress.• If a maternal cause is identified (e.g. maternal fever, drugs), initiateappropriate management.• If a maternal cause is not identified and the fetal heart rateremains abnormal throughout at least three contractions, performa vaginal examination to check for explanatory signs of distress:- If there is bleeding with intermittent or constant pain, suspectabruptio placentae (page S-18);- If there are signs of infection (fever, foul-smelling vaginaldischarge) give antibiotics as for amnionitis (page S-139);