Suspected loss of fetal well-being

It is called loss of fetal well-being when alterations that compromise the oxygenation of the fetus are detected. It is a situation in which it may be necessary to terminate the pregnancy to preserve the health of the mother and the fetus. 

The most frequent causes are placental insufficiency and feto-maternal hemorrhage. The risk is higher in pregnant women over 40 years of age, hypertensive, overweight, with diabetes and/or smoking.  

It usually presents with few signs, the most relevant being maternal perception of decreased fetal movements. As pregnancy progresses, fetal movements appear progressively; adequate acquisition and maintenance of these movements indicate correct neuromuscular development, as well as fetal well-being.

It is diagnosed by clinical questioning where it is important to establish when the mother has detected the decrease in movements. An ultrasound is performed to assess fetal movements, heart rate, amniotic fluid volume and fetal and placental vascularization. It is usually accompanied by a cardiotocographic recording to assess uterine contractions and how they affect the fetal heartbeat.

The results of these tests are essential to allow spontaneous evolution or to induce labor.