Meconium in the amniotic fluid
If a fetus has meconium in their lungs when they are born, this prevents the pressure in their lungs from falling, which normally facilitates the transition to independent breathing. Since aspiration of meconium can lead to improper oxygenation due to obstruction and carries the potential risk for inflammatory pneumonitis, this is an important diagnosis to make in the setting of newborn respiratory distress. Gestational Hypertension
If hypertension in the mother occurs after the 20th week and meets certain criteria, this is considered preeclampsia/eclampsia. The mechanism of preeclampsia/eclampsia is unknown, but consequences if left untreated can include fetal growth restriction or death, as well as pose medical risks to the mother. Signs and symptoms of preeclampsia can include swelling, protein in the urine, headaches, vomiting, and abnormal labs that assess kidney and liver function, some of which may be considered severe preeclampsia or eclampsia. Post-term pregnancy
Breathing problems
Anemia
Abnormal position and presentation of the fetus
Multiple births
Shoulder dystocia
Umbilical cord prolapse
Nuchal cord
Placental abruption
Premature closure of the fetal ductus arteriosus
Uterine rupture
Intrahepatic cholestasis of pregnancy, a liver disorder during pregnancy
Maternal diabetes (Type 1 or 2) or gestational diabetes (GDM)

Prevention
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 mothers contractions, and monitor the mothers blood pressure and systemic symptoms for gestational hypertension, preeclampsia, or eclampsia.
Treatment
Instead of referring to "fetal distress", current recommendations hold to look for more specific signs and symptoms, assess them, and take the appropriate steps to remedy the situation through the implementation of intrauterine resuscitation. 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. References


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