How Should The NICU React To Complications From A Delayed Fetal Distress Response?

Fetal distress, also called non-reassuring fetal status, can become an emergency in an instant, and sometimes doctors have only minutes in which to act before an unborn child dies or experiences permanent injury. If a fetus is in distress for too long, the neonatal intensive care unit, or NICU, should be standing by to respond to any potential complications.

What Is Fetal Distress?

When a fetus shows signs of distress during late pregnancy or labor, it usually presents as a change in heart rate or reduced movement. Doctors check for signs of distress during routine check-ups and throughout the labor process.

Fetal distress can occur for various reasons, including:

• problems with the health of the mother: anemia, preeclampsia, abnormally low blood pressure, or chronic disease
• problems with the fetus: anemia, fetal growth restriction, multiple fetuses, greater than 41 weeks gestation, or low amniotic fluid levels
• problems with the placenta or umbilical cord: placental abruption (separation from the uterus before birth), placenta previa (blocking the cervix), or umbilical cord prolapse, compression, or entanglement
• problems with the contractions: too frequent, too strong, or lasting too long without giving time for the baby to recover

How Is Fetal Distress Treated?

During labor, the fetal heart rate is monitored (either continuously or periodically) for any signs of distress. When it’s detected, initial treatments include:

• changing the position of the mother
• giving the mother supplemental oxygen or IV fluids
• giving medicine to slow or stop contractions
• stopping medications that are causing contractions
• amnioinfusion (injecting additional fluid in the amniotic sac to relieve umbilical cord compression)

If none of these methods work, or if fetal distress becomes severe or prolonged, it’s considered an emergency that requires immediate action. If the mother is fully dilated and the baby is in a good position, the doctor may attempt an assisted delivery using forceps or a vacuum extractor. If this is not possible, then an emergency c-section may be required.

What Complications Can Occur As A Result Of Fetal Distress?

Fetal distress, if not addressed quickly, can lead to serious immediate complications for the baby. Prolonged lack of oxygen can cause brain injury, seizures, and stillbirth. A fetus in distress can also pass their first stool (meconium) into the amniotic fluid and inhale it, which can result in severe respiratory problems.

Long-term complications for babies who experienced fetal distress include:

• cerebral palsy
• learning disabilities
• developmental delays
• vision or hearing impairments
• seizure disorders
• speech and language problems
• difficulty with balance or coordination

How Should A NICU Respond In Situations Of Fetal Distress?

For babies whose fetal distress is not identified or corrected quickly enough, short- and long-term complications are likely. The NICU should be notified and standing by for these babies, ready to provide immediate care. Initially, they will focus on stabilizing the baby’s condition by providing:

• respiratory support with oxygen or a ventilator if needed
• placement in an incubator or under a warming light to maintain a stable body temperature
• placement of an IV line so that fluids and medications can quickly be given directly into the bloodstream if they’re needed in an emergency
• placement of sensors to track vital signs like heart rate, breathing, and temperature

After the baby is stabilized, NICU staff will examine the newborn for signs of potential brain injury or other complications. If it’s believed that they experienced brain injury from a prolonged lack of oxygen, one option that should be considered is therapeutic hypothermia or whole-body cooling. While not every baby can go through this process safely, and the necessary equipment and expertise are not available in every hospital, babies who meet the treatment criteria should be treated or transferred to a NICU that can provide this treatment whenever possible.

To be most effective, therapeutic hypothermia should begin in the first 6 hours after birth. Therapeutic hypothermia works by lowering the baby’s body temperature to around 92 degrees Fahrenheit and keeping it there for 72 hours. This process helps stop further brain damage and gives the brain a chance to heal. The baby is then slowly returned to a normal body temperature and reassessed. Infants who receive this treatment are more likely to survive and have a lower risk of serious long-term complications.

Why Choose Ross Feller Casey For Your Birth Injury Case?

Fetal distress can be frightening for the entire family, particularly when the long-term complications are unknown. Unfortunately, it’s not always possible to identify and treat fetal distress immediately. Because of this, NICU doctors and nurses must act quickly to stabilize and treat babies who are experiencing complications after fetal distress.

Suppose a doctor, nurse, or entire NICU department is negligent in their care of a baby that has experienced significant oxygen deprivation before or during birth. In that case, that child, if it survives, can be left with catastrophic injuries that affect them for the rest of their life. When this occurs, the legal team at Ross Feller Casey is here for you.

We’ve built a reputation for success regarding medical malpractice cases, including those involving fetal distress and NICU complications. We’ve recovered over $3 billion for our clients, including hundreds of multimillion-dollar recoveries, and we’re ready to put our expertise to work for you. There’s no fee unless you win. Consultations are always free, so contact us today.