Assessment of fetal well-being

Fetal well-being is a fetus of:

1- Normal Growth

2- No Congenital fetal malformations seen

2- Free of distress

Fetal distress is fetus suffering from any

or all of the following:

- Hypoxia = Reduced oxygen tension

- Asphyxia = Hypoxia + Rise of CO2

- Acidosis = Asphyxia + accumulation of

acid metabolite products of anaerobic

oxidation

- Ischemia = Reduced blood flow

1- Clinical background of the patient and Fetal

activity: Tools to diagnose fetal distress should be

interpreted in context with the clinical background

of the patient. A fetus with normal fetal kick-chart

and normal growth pattern and average amniotic

fluid and showing normal activity during ultrasound

scan, is hardly suffering from distress.

2- Ultrasound study of

- Fetal growth pattern,

- Amniotic fluid volume and consistency,

- Placental grading

- Uteroplacental Flow (Mainly Umbilical artery)

- Changes in fetal circulation

- Antenatal NST and BPP

- Intrapartum CTG (Cardiotocography)

trace

- Intrapartum STAN analysis (ST segment

analysis)