management of Fetal Distress

1. TITLE:

management of Fetal Distress

2. PURPOSE:

1. Management of  fetal distress.

2. To call upon medical aid for timely intervention

3. CONDITION/ APPLICABILITY:

This policy applies to all obestatrical team,pediatric team, Nursing and Midwifery Staff.

4. DEFINITION:

Compromise of a fetus during the antepartum period or intrapartum period . The term fetal distress is commonly used to describe fetal hypoxia  , which can result in fetal damage or death if it is not reversed or if the fetus is not promptly delivered. Fetal distress can be detected by pathological CTG or abnormal PH in fetal scalp blood sampling and confirmed by cord PH after delivery . 

5. POLICY:

All patients in labor will have clinical assessment  and continuous CTG monitoring for early detection of fetal distress.

6. PROCEDURE:

1. A patient with fetal distress should be:

1. Put in left lateral position .

2. Administer oxygen via mask at 4 – 6 L/min.

3. Support emotionally and reassurance.

2. Fetal distress of any kind should be reported to the Obstetrician, time of informing Documented in the Nurse’s Notes and on Partogram.

3. If Oxytocin infusion is in progress, stop the infusion immediately and keep the vein open with Lactated Ringer’s Solution or Dextrose 5% in LR, while awaiting the Obstetrician’s arrival ( midwife can do vaginal  examination before the obstetrician comes )

4. Pediatrician call should be informed in case of fetal distress by the Obstetrician .

5. When fetal distress occur chart time started:

1. On CTG graph.

2. Time OB Specialist is informed.

6. On Obstetricians arrival , Document time on CTG graph and Partogram.

7. Follow Obstetricians orders for patient management.

8. Document procedures and observations made in the Nurse’s Notes.

9. Senior registrar or consultant should review the patient history /examination and clear plan should be document in the patient file 

7. RESPONSIBILITY:

1. Obstetrical team

2. Nursing and Midwifery Staff.

8. FORMS/ EQUIPMENT:

1. CTG monitor

2. Indwelling catheter

3. Labor partogram

4. Nurses note

9. REFERENCE:

Lab Guidelines and Standards, Journal of Medical Screening, Volume 16, Number 3, pg. 119-123, 2008.

10. REVISION:

11. APPROVALS: