Fetal distress, also known as non-reassuring fetal status, is a condition during pregnancy or labor in which the fetus shows signs of inadequate oxygenation.

Due to its imprecision, the term “fetal distress” has fallen out of use in American obstetrics. The term “non-reassuring fetal status” has largely replaced it. It is characterized by changes in fetal movement, growth, heart rate, and the presence of meconium-stained fluid.

Risk factors for fetal distress/non-reassuring fetal status include anemia, restriction of fetal growth, gestational parent/maternal hypertension or cardiovascular disease, low amniotic fluid or meconium in the amniotic fluid, or a post-term pregnancy. The condition is detected most often with electronic fetal heart rate (FHR) monitoring through cardiotocography (CTG), which allows clinicians to measure changes in the fetal cardiac response to declining oxygen. Specifically, heart rate decelerations detected on CTG can represent danger to the fetus and to delivery.

Treatment primarily consists of intrauterine resuscitation, the goal of which is to restore oxygenation of the fetus. This can involve improving the position, hydration, and oxygenation of the mother, as well as amnioinfusion to restore sufficient amniotic fluid, delaying preterm labor contractions with tocolysis, and correction of fetal acid-base balance. An algorithm is used to treat/resuscitate babies in need of respiratory support post-birth.