What Are the Risk Factors for Fetal Acidosis?

Last Updated on January 17, 2025 by Michelle Wan

Fetal acidosis is a serious condition in which a baby’s blood becomes excessively acidic due to inadequate oxygen supply during pregnancy or labor. If left untreated, this condition can lead to hypoxic-ischemic encephalopathy (HIE), brain injury, organ dysfunction, or even stillbirth. Understanding the risk factors for fetal acidosis is essential for healthcare providers and expecting parents to take proactive steps in preventing complications and ensuring a safe delivery.

This blog will explore the risk factors, causes, and potential consequences of fetal acidosis, as well as preventive measures that can help improve outcomes for both mother and baby.

What Is Fetal Acidosis?

Fetal acidosis occurs when the baby’s blood pH drops below 7.2, indicating excessive acidity due to oxygen deprivation (hypoxia). Normally, a baby receives oxygen through the placenta, but if the oxygen supply is disrupted, the baby’s body switches to anaerobic metabolism, leading to lactic acid buildup. This acid-base imbalance can cause severe complications if not addressed promptly.

Major Risk Factors for Fetal Acidosis

Several maternal, fetal, and delivery-related factors can contribute to fetal acidosis. Understanding these risk factors allows healthcare providers to monitor high-risk pregnancies and take preventive action when necessary.Maternal Health Conditions

Certain maternal conditions can interfere with oxygen delivery to the baby, increasing the risk of fetal acidosis:

• Preeclampsia – High blood pressure during pregnancy can restrict placental blood flow, reducing oxygen supply.
• Gestational Diabetes – Can cause placental insufficiency, increasing the risk of fetal hypoxia.
• Anemia – If the mother has low hemoglobin levels, there may not be enough oxygen carried to the fetus.
• Infections (e.g., Chorioamnionitis) – Infections affecting the uterus or amniotic fluid can cause inflammation and placental dysfunction.
• Obesity – Increases the risk of pregnancy complications, including gestational diabetes and preeclampsia, both of which can contribute to fetal acidosis.

Placental and Umbilical Cord Issues

The placenta and umbilical cord are responsible for providing oxygen and nutrients to the baby. Any condition that disrupts their function can result in oxygen deprivation and acid buildup:

• Placental Insufficiency – The placenta does not provide adequate oxygen or nutrients to the fetus, increasing acidosis risk.
• Placental Abruption – Premature separation of the placenta from the uterine wall can cut off oxygen supply.
• Umbilical Cord Compression – The cord becomes compressed, reducing blood flow to the baby and leading to hypoxia.
• Umbilical Cord Prolapse – The cord slips through the cervix before the baby, potentially cutting off oxygen circulation.

Labor and Delivery Complications

Difficulties during labor can increase fetal stress and oxygen deprivation, leading to fetal acidosis. These include:

• Prolonged Labor – Extended labor places stress on the baby, increasing the risk of oxygen deprivation.
• Uterine Hyperstimulation – Excessive contractions (caused by Pitocin or natural overstimulation) reduce the time between contractions, limiting oxygen exchange between contractions.
• Delayed Cesarean Section (C-Section) – Failure to perform a C-section when indicated can lead to prolonged oxygen deprivation.
• Forceps or Vacuum Extraction – Improper use of these tools can cause physical trauma, contributing to fetal distress.

Fetal Conditions

Certain fetal conditions can make a baby more vulnerable to acidosis:

• Fetal Growth Restriction (FGR/IUGR) – Babies with poor growth in the womb may have compromised oxygen delivery.
• Large Birth Weight (Macrosomia) – Babies weighing over 8 lbs 13 oz may have difficulty passing through the birth canal, increasing the risk of oxygen deprivation.
• Multiple Gestation (Twins, Triplets, etc.) – Higher likelihood of placental insufficiency, preterm labor, and umbilical cord complications.
• Congenital Heart or Lung Abnormalities – Babies with underdeveloped heart or lung function struggle with oxygenation, increasing their risk of acidosis.

Medical Negligence

In some cases, medical errors and negligence can contribute to fetal acidosis. These include:

• Failure to Monitor Fetal Distress – If fetal heart rate abnormalities are ignored, acidosis can progress without intervention.
• Delayed Response to Emergencies – Not performing a C-section in time can prolong oxygen deprivation.
• Misuse of Labor-Inducing Drugs – Excessive Pitocin can overstimulate contractions, limiting fetal oxygenation.
• Improper Use of Delivery Tools – Misuse of forceps or vacuum extractors can cause trauma, increasing fetal distress.

If medical negligence played a role in fetal acidosis, parents may have legal options to seek compensation for their child’s injuries.

How Is Fetal Acidosis Diagnosed?

Doctors use several monitoring tools to detect signs of fetal acidosis early:

1. Fetal Heart Rate (FHR) Monitoring – Identifies irregular heart rate patterns, which can indicate oxygen deprivation.
2. Fetal Scalp Blood Sampling – Measures pH levels directly from the baby’s scalp during labor.
3. Umbilical Cord Blood Gas Analysis – Conducted immediately after birth to assess blood pH and oxygen levels.
4. Biophysical Profile (BPP) – Uses ultrasound and non-stress tests to evaluate fetal well-being.

Early detection allows for timely intervention, reducing the risk of long-term complications.

Preventing Fetal Acidosis

While some cases of fetal acidosis are unavoidable, proactive steps can help reduce the risk:

1. Prenatal Care
   • Regular monitoring of maternal health, fetal growth, and placental function.
   • Early management of conditions like gestational diabetes and preeclampsia.
2. Proper Labor Management
   • Monitoring fetal heart rate throughout labor and delivery.
   • Reducing prolonged labor stress by considering early intervention when needed.
   • Avoiding excessive use of Pitocin to prevent uterine overstimulation.
3. Emergency Response Readiness
   • Immediate decision-making in cases of fetal distress.
   • Ensuring hospitals have emergency C-section protocols in place.

By identifying risk factors early and taking necessary precautions, healthcare providers can help reduce the occurrence of fetal acidosis and improve birth outcomes.

Legal Options for Families Affected by Fetal Acidosis

If medical negligence contributed to fetal acidosis and resulted in complications such as hypoxic-ischemic encephalopathy (HIE), cerebral palsy, or developmental delays, parents may have legal grounds to file a medical malpractice claim. Compensation may cover:

• Medical expenses (hospital care, therapy, ongoing treatments).
• Rehabilitation costs (physical therapy, speech therapy, special education needs).
• Pain and suffering caused by preventable birth injuries.

If you believe medical negligence played a role in your baby’s fetal acidosis diagnosis, consulting with an experienced birth injury attorney can help you understand your legal rights.

How Thomas & Wan LLP Can Help

At Thomas & Wan LLP, we specialize in birth injury cases, helping families seek justice for medical malpractice that leads to conditions like fetal acidosis, HIE, and cerebral palsy. Our legal team will:

• Review medical records to determine whether negligence occurred.
• Consult with medical experts to assess the standard of care provided.
• Fight for the compensation your family needs to provide the best care for your child.

If you suspect medical negligence in your baby’s birth injury, contact Thomas & Wan LLP today for a free consultation.

Fetal acidosis is a serious but often preventable condition. By understanding the risk factors, expecting parents and healthcare providers can work together to reduce complications and ensure the safest possible delivery.

If medical negligence contributed to your baby’s condition, seeking legal guidance can help secure the financial support and justice your family deserves.