Definition Fetal distress is defined as depletion of oxygen and accumulation of carbon dioxide, leading to a state of "hypoxia and acidosis" during intra uterine life
Fetal distress is defined as depletion of oxygen and accumulation of carbon dioxide,leading to a state of “hypoxia and acidosis ” during intrauterine life. Definition
Etiology Maternal factors 1)Microvascular ischaemia(PIH 2)Low oxygen carried by rBc(severe anemia) 3) Acute bleeding(placenta previa, placental abruption 4)Shock and acute infection 5)obstructed of Utero-placental blood flow
Maternal factors 1) Microvascular ischaemia(PIH) 2) Low oxygen carried by RBC(severe anemia) 3) Acute bleeding(placenta previa, placental abruption) 4) Shock and acute infection 5) obstructed of Utero-placental blood flow Etiology
Etiology Placenta umbilical factors 1)Obstructed of umbilical blood flow 2)Dysfunction of placenta 3)Fetal factors 4) Malformations of cardiovascular system 5)Intrauterine infection
Placenta、umbilical factors 1) Obstructed of umbilical blood flow 2) Dysfunction of placenta 3) Fetal factors 4) Malformations of cardiovascular system 5) Intrauterine infection Etiology
Pathogenesis Hypoxia accumulation of carbon dioxide Respiratory Acidosis Acute fetal FHR→FHR↓→FHR↑ distress Intestinal peristalsis Relaxation of the anal sphincter Meconium aspiration Fetal or neonatal pneumonia
Hypoxia、accumulation of carbon dioxide ↓ Respiratory Acidosis ↓ FHR↑ → FHR ↓→ FHR ↑ ↓ Intestinal peristalsis ↓ Relaxation of the anal sphincter ↓ Meconium aspiration ↓ Fetal or neonatal pneumonia Pathogenesis Acute fetal distress
Pathogenesis Chronic TUGR Feta (intrauterine growth distress retardation)
Chronic Fetal distress Pathogenesis IUGR (intrauterine growth retardation)
clinical manifestation Acute fetal distress (1)FHR FHR>180 beats/min(tachycardia) <100 beats/min(bradycardia) (LD) Repeated Late deceleration Placenta dysfunction (VD) Variable deceleration Umbilical factors
Clinical manifestation Acute fetal distress (1)FHR FHR>180 beats/min (tachycardia) <100 beats/min (bradycardia) (LD) Repeated Late deceleration Placenta dysfunction (VD) Variable deceleration Umbilical factors
FHR: 120N160 bpm /FHR variability 1501 mwwmmMwwwwnw 每胎90胎心率周期性变化 分心 钟率 50 宫腔压力 (mmHg o 每胎901m%m 分心 钟率 30 50 (am0心率基线与基线摆动(心率周期性变化) 图6-12胎心率与基线摆动 C MmhG= 0. 133kPa
FHR:120~160 bpm / FHR variability