From the Research
Fetal distress accounts for approximately 11.5% of all cesarean deliveries, as reported in a recent study published in 2022 1. This proportion may vary by institution, region, and country based on different practice patterns and interpretation of fetal monitoring. Fetal distress, now more accurately termed "non-reassuring fetal status," is diagnosed when there are concerning signs that the fetus may not be receiving adequate oxygen, typically identified through abnormal fetal heart rate patterns on electronic monitoring or concerning findings on fetal scalp sampling. These patterns may include late decelerations, severe variable decelerations, prolonged bradycardia, or minimal to absent variability. When these signs are detected, healthcare providers must decide whether immediate delivery via cesarean is necessary to prevent potential hypoxic injury to the fetus. Some key points to consider include:
- The diagnosis of fetal distress should not be made only with fetal heart rate changes in CTG, as this can cause excessive fetal distress diagnosis and many unnecessary cesarean operations 1.
- Efforts to standardize the interpretation of fetal heart rate tracings and implement intrauterine resuscitation measures before proceeding to cesarean delivery may help reduce the cesarean rate for this indication.
- A study from 2019 reported that fetal distress was the most common indication of cesarean section, accounting for 28% of all cesarean deliveries 2.
- Another study from 2005 found that therapeutic amnioinfusion using a pediatric feeding tube can reduce the rate of cesarean section for fetal distress and improve neonatal outcomes 3. However, the most recent and highest quality study, published in 2022, reported a cesarean rate due to fetal distress of 11.5% 1, which should be considered the most accurate estimate.