Suppose fetal blood sampling is technically not possible for one reason or another or the parents object to it - what then?
If suspicious findings such as an abnormal CTG and passage of thick fresh meconeum cannot be verified, then a caesarean section becomes inevitable. This is not a situation in which one can afford to take risks - better be safe than sorry.
Would you say premature fetuses are at increased risk of distress in labour?
Not particularly, no. Small-for-dates babies whose growth during pregnancy has been sub-optimal are a different case. These babies are prone to fetal distress because of their inherent ‘weak’ state and the common problem of reduced amniotic fluid, and therefore the increased risk of cord compression.
What is the risk of permanent brain damage as a result of fetal distress?
The oxygen deprivation needs to be severe and prolonged for this eventuality to occur. This is therefore a rare consequence of fetal distress in labour. Even for babies that are born floppy with a delayed cry and who end up in special care baby units for several days, the vast majority of them make a full recovery.
It is those unfortunate babies where the insult to the brain goes unsuspected and therefore unrecognised for prolonged periods in pregnancy where cerebral palsy may eventually result. The same applies to acute episodes of serious conditions such as uterine rupture or severe placental abruption.