Diagnosis and management of fetal distress.

Both biophysical and biochemical techniques may be used to diagnose fetal distress. Fetal heart rate monitoring should be thought of as a screening technique to define a population at significant risk for fetal acidosis. The addition of fetal scalp blood sampling improves the clinician's diagnostic accuracy. The hallmark of treatment is to alleviate the stress on the fetus, to restore intervillous and cord blood flow, and, hence, to improve fetal oxygenation. This improvement may be accomplished by (1) discontinuing oxytocin, (2) correcting maternal hypotension, (3) administering oxygen to the mother, and (4) attempting to alleviate cord compression by changing the relationship of the fetal presenting part to the umbilical cord and pelvis.