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What Are the Signs of Fetal Distress?

Written by Berkowitz

woman huddled in the corner

Common signs your baby is in distress in the womb include heart rate irregularities, decreased fetal movement, intense cramping (in the mother), vaginal bleeding (in the mother), excess or insufficient weight gain, abnormal levels of amniotic fluid, and other well-recognized symptoms.

Your health care provider is responsible for recognizing symptoms of fetal distress and responding appropriately. If they fail to do so, your infant could suffer serious medical complications or even death. In that case, a medical malpractice lawsuit would be more than appropriate.

Causes of Fetal Distress

A mother who is suffering from distress.The following are just a few of the known underlying causes of fetal distress:

  •  Abnormal fetal position (breech position, for example);
  •  Anemia;
  • Medical misuse of forceps or vacuum extractors;
  • Placental abruption (placental separation from the uterus);
  • Post-term pregnancy;
  • Preeclampsia;
  • Pregnancy-induced high blood pressure;
  • Problems with the umbilical cord (wrapped around the neck, etc.);
  • Prolonged and arrested labor; and
  • Rupture of the uterus.

A full list of the conditions that might cause fetal distress would be too extensive to include here and not all of them are known.

Signs of Fetal Distress

The signs your baby is in distress in the womb can be subtle, and you might miss them if your doctor is not closely monitoring your pregnancy. Many of them occur well before childbirth. Some of the most common fetal distress signs are described below.

Decreased Movement

It is generally a sign of health when your baby kicks in your womb. Since babies sleep in the womb just as they sleep most of the time during the first few weeks after birth, you can expect the fetal movement to pause and resume repeatedly. If your womb goes silent, however, or if fetal movement decreases markedly, your infant might have a problem. If this happens, your doctor should conduct testing.

Abnormal Heart Rate

Your infant might be in distress if their heart rate is too high (tachycardia), too low (brachycardia), or unstable. “Unstable” means (i) subject to sudden bouts of temporary brachycardia or (ii) too slow to return to normal after a labor contraction (which usually causes a slowing of the fetal heart rate).

A doctor will use a fetal monitoring device to test your infant’s heart rate. This device might be external, using a belt that wraps around your abdomen. An internal monitoring device, by contrast, will actually make contact with the baby inside your womb. Your doctor must then analyze the heart rate monitor for signs of irregularity.  Two other ways of detecting fetal heart rate abnormalities are the non-stress test (NST) and the contraction stress test (CST).

Abnormal Amniotic Fluid Level

Amniotic fluid is the liquid that the baby floats in prior to birth. Too little or too much amniotic fluid could indicate fetal distress.  Abnormally low amniotic fluid volume is known as oligohydramnios, while abnormally high amniotic fluid volume is known as polyhydramnios. Both of these conditions can lead to oxygen deprivation and birth injuries. In extreme cases, even death might result.

Vaginal Bleeding

Vaginal bleeding in the mother can indicate serious problems with a pregnancy. Some spotting is normal. But if bleeding lasts for more than a few hours or is heavy, you should call your doctor.

One serious condition that vaginal bleeding may indicate is placental abruption, which is when the placenta tears apart from the mother’s womb. This leads to a deprivation of oxygen for the infant, as well as serious health risks for the mother.

If a placental abruption or a similar placental problem does occur, your doctor should monitor the situation very closely, even to the point of admitting you to the hospital. In extreme cases, you may even need a C-section.

Severe Cramping

A certain amount of cramping, and its associated pain, is normal and all too common during pregnancy. As the baby grows, the uterus expands, resulting in cramping. If these cramps become intense or long-lasting, however, trouble could be on the horizon. Serious cramping could be a sign of:

  • Miscarriage,
  • Urinary tract infection,
  • Preeclampsia,
  • Placental abruption,
  • Premature labor, or
  • Another condition.

A competent doctor will recognize when cramping is normal and when further testing is required.

Abnormal Maternal Weight Gain

Weight gain during pregnancy is normal. Experts believe a gain of about 30 pounds is typical, although this amount varies depending on the mother’s pre-pregnancy weight. The ideal amount of weight gain is less for overweight mothers and greater for underweight mothers. Mothers carrying twins are expected to gain more weight as well.

If the mother gains less than the amount considered normal for her pre-maternal weight, it could mean low birth weight and possibly other problems for the infant. Careful monitoring of the situation is critical, and early delivery may be the appropriate remedy.

If the mother gains significantly more weight than is considered normal, the infant may be born excessively large (a condition known as macrosomia). Macrosomia is particularly dangerous for the infant during birth, due to the risk of cephalopelvic disproportion (CPD), where the baby’s head is too large to fit through the mother’s pelvis, or shoulder dystocia, where the infant’s shoulder gets stuck inside the mother’s pelvis during childbirth

Malpractice often occurs in macrosomia cases when the doctor insists in persisting with a vaginal birth when a C-section is called for. The danger is intensified if the doctor uses drugs, forceps, or a vacuum extractor to force vaginal delivery. Head injuries, brain damage, and oxygen deprivation are all possible consequences of this form of medical malpractice.

Treatment of Fetal Distress

The primary treatment used for fetal distress is intrauterine resuscitation, a procedure that ensures that the infant will receive adequate blood and oxygen. Intrauterine resuscitation is accomplished through:

  • Changing the mother’s body position;
  • Making sure that the mother has plenty of water;
  • Providing the mother with sufficient oxygen;
  • Inserting fluid into the amniotic cavity to prevent compression of the umbilical cord;
  • Delaying labor by temporarily ceasing contractions; and
  • Injecting hypertonic dextrose into the mother.

In addition to the foregoing measures, your doctor may ultimately need to perform a C-section. The situation may demand certain other measures as well, depending on the details of your pregnancy.

Fetal Distress and Medical Malpractice: Do I Have a Case?

Doctors walk a fine line when dealing with fetal distress. A doctor must monitor the signs carefully, detect fetal distress as promptly as it occurs, and undertake the appropriate treatment immediately. A delay of only five minutes (or even less in some cases) could cause severe hypoxia and result in lifelong consequences for your infant. On the other hand, a doctor should not institute aggressive treatment measures when no real distress exists.

Nevertheless, it is your doctor’s professional duty to respond to possible fetal distress signs by taking them seriously. Your doctor should have the resources and skills to monitor the situation and take action before your infant suffers permanent damage or even death. Grounds for a medical malpractice lawsuit may exist if your doctor should have noticed certain fetal distress signs but did not react appropriately.

How to Establish a Medical Malpractice Claim Based on Inappropriate Response to Fetal Distress

To prove that your healthcare provider is liable for your child’s birth injury, you will have to provide evidence of a delay in diagnosing or treating fetal distress. You will have to prove that this delay was inappropriate and that it constituted medical negligence. Finally, you will have to prove that this inexcusable delay actually caused your child’s injuries.

In almost every medical malpractice case, you will need an expert medical expert witness, most likely a former doctor, to testify that a reasonably competent health care provider would not have delayed diagnosis or treatment the way your health care provider did. Many knowledgeable experts routinely testify at medical malpractice trials, and Berkowitz Hanna enjoys strong relationships with several of them.

You are also likely to need to gather certain evidence, such as medical records, that are in the possession of your health care provider. This might require you to file a medical malpractice lawsuit and seek a court order demanding the production of these records. You will probably need the help of a medical expert witness to generate a “reasonable inquiry” certification that is a prerequisite for filing a medical malpractice lawsuit in Connecticut.

Defective Medical Equipment and Products Liability

A fetal distress case in a hospital.In some cases of fetal distress, the ultimate responsibility lies not with the health care provider, but with the manufacturer of the medical equipment that monitored the infant’s vital signs. The manufacturer does not always bear liability, however. The equipment may have failed because it was inadequately maintained, for example, which would indicate that the health care provider, not the manufacturer, bears liability.

If the doctor failed to respond to fetal distress because of an inherent defect in the medical equipment, it may be possible for you to file a product liability claim against the manufacturer or distributor of the faulty medical equipment. You can win such a lawsuit without even proving that the defendant was at fault.

Wrongful Death Claims

If your child died due to medical negligence or products liability, the executor or administrator of your child’s estate can file a wrongful death claim seeking monetary damages from the defendants. A court can appoint an administrator for your child’s estate, and when the deceased is an infant, the court will almost always appoint a parent.

Don’t Try to Handle This Alone

If your child has suffered a birth injury, or if your child died before birth, during birth, or shortly after birth, medical malpractice may have something to do with it. Contact Berkowitz Hanna for a free, no-obligation consultation. Call us or contact us online to begin the claims process today. And remember—if we don’t win, you don’t pay.