Жұқтың жетілмеуі және жаңа туған балалардың күтімі

Paediatric and children's diseases
Fetal distress, also known as non reassuring fetal status, is a condition during pregnancy or labor in which the fetus shows signs of inadequate oxygenation. Due to its imprecision, the term "fetal distress" has fallen out of use in American obstetrics. The term "non reassuring fetal status" has largely replaced it. It is characterized by changes in fetal movement, growth, heart rate, and presence of meconium stained fluid. This can involve improving the position, hydration, and oxygenation of the mother, as well as amnioinfusion to restore sufficient amniotic fluid, delaying preterm labor contractions with tocolysis, and correction of fetal acid base balance.

Monitoring of the mother and fetus prior to birth is critical to avoid complications after birth. This is often done via electronic fetal heart rate (FHR) monitoring, which helps providers monitor the fetus' heart rate to ensure it is receiving enough oxygen, monitor the mother's contractions, and monitor the mother's blood pressure and systemic symptoms for gestational hypertension, preeclampsia, or eclampsia. Traditionally the diagnosis of "fetal distress" led the obstetrician to recommend rapid delivery by instrumental delivery or by caesarean section if vaginal delivery is not advised. An algorithm is used to treat/resuscitate babies in need of respiratory support post birth. The algorithm steps include: clearing the airways and warming, stimulating, and drying the baby, positive pressure ventilation (PPV), supplementary oxygen, intubation, chest compressions, and pharmacological therapy. The order of these interventions is set, and each step is done for 30 seconds with heart rate monitoring and assessment of chest movement prior to escalating to the next step in the algorithm.