Chronic intrauterine fetal hypoxia causes. Oxygen starvation of the fetus

When, after examination by a doctor, a pregnant woman finds out that she has a diagnosis of intrauterine fetal hypoxia, she enters into a restless state. Expectant mothers have questions about this diagnosis, the consequences and methods of its prevention.

What is fetal hypoxia

The condition of the fetus resulting from a lack of oxygen supplied through the maternal placenta is called fetal hypoxia. According to available statistics, fetal hypoxia in the countries of the former Soviet Union is recorded in 21 out of 200 births.

A baby in the womb receives vital oxygen for itself through the placenta of its mother.

The vessels of the uterus and placenta are interconnected at the child's place, where the placenta is bonded to the fetus. The supply of nutrition from maternal blood to the fetus just occurs through such vessels. The child feels a lack of any components when they are deficient in the mother's body (in this case, we are talking about oxygen).

The child's condition does not change in any way from a slight hypoxia. And severe and moderate fetal hypoxia leads to necrosis and ischemia in certain organs of the baby, to the most unpleasant consequences and to the likelihood of death.

Lack of oxygen at different stages of pregnancy can have a variety of consequences for the child. If it occurs in the first stages of pregnancy, the child develops in the mother's womb more slowly, an abnormal development appears. There is a high risk that the baby will not be able to feel normal in the future. Later stages of hypoxia affect the central nervous system, delay the development of the child, and significantly reduce its adaptive capabilities.

Causes of fetal hypoxia

There are a lot of factors that influence the development of fetal hypoxia. First, a diagnosis of diseases in a pregnant woman should be carried out in order to reject the fact of the appearance of anemia. The presence of this disease implies a disruption in the work of red blood cells, provoking an improper supply of oxygen to important cells in the body.

If there are heart defects, diseases of the muscular middle layer of the heart, lung diseases, myocardial diseases, as well as with increased stress on these organs, pregnant women most often develop insufficient blood flow. With poor blood circulation, a violation of microcirculation in tissue cells is recorded, which leads to the gradual development of fetal hypoxia and disruption of the functioning of the system between the mother, placenta and fetus.

The quality of the course of pregnancy also depends on the presence or absence of diseases of the respiratory system. Such diseases appear as a result of respiratory failure, which leads to hypoxia of the organs and tissues of the pregnant woman and affects the fetus. Fetal hypoxia can develop due to kidney disease, diabetes.

Fetal hypoxia can also occur for other reasons, in which the fetal-placental blood flow is disturbed, which occurs in cases associated with prolonged pregnancy, the appearance of a threat that childbirth will occur prematurely, pathological changes in the placenta and umbilical cord, etc.

Fetal hypoxia can be the result of the development of fetal diseases: hemolytic disease (a condition that occurs if the child's blood type is not compatible with the blood type of the expectant mother), prolonged compression of the baby's head during childbirth.

Symptoms of fetal hypoxia

The main symptom of fetal hypoxia is a change in the rhythm of the baby's heartbeat. The fetal heart rate in normal mode is 120-160 beats / min. The heartbeat may be characterized by small deviations. And with a jump in heart rate from 160 to 90-100 beats / min, the appearance of hypoxia is recorded. Fetal hypoxia also appears when the fetus's heart rate is less than 70 bpm. For the correct diagnosis of fetal hypoxia, the following are used: cardiotography, examination of the state of amniotic fluid, dopplerometry, a blood test of a pregnant woman (hormonal and biochemical methods), auscultation, fetal electrocardiography.

Fetal hypoxia can be determined by a woman on her own in the later stages of pregnancy, observing changes in the movements of the baby. At the initial stage of hypoxia, the child becomes anxious, he begins to move often and strongly. The weakening of its movement is fixed with the progression of hypoxia.

A symptom of the need for an urgent visit to a doctor is the movement of the child less than three times within an hour and their repetition, as well as the situation when the activity of the baby eventually passes into its absence.

Types of fetal hypoxia

1. Chronic fetal hypoxia. This type of fetal hypoxia is most often due to untimely diagnosis of pathology. Chronic fetal hypoxia is possible in the absence of timely diagnosis of complications. As a result of the development of chronic hypoxia, the formation of organs and the process of fetal development are disrupted even at the stage of the embryo. At the same time, pathological changes in the fetal central nervous system can develop, physical development is significantly impaired, which leads to growth retardation, difficulty in adapting the infant to life outside the mother's womb. A child experiencing chronic hypoxia does not want to eat, behaves restlessly and has various disorders in the functioning of the autonomic and nervous systems.
2. Acute fetal hypoxia. At any stage of pregnancy and even during labor, an acute form of this pathology can occur. In the acute form of hypoxia, strict monitoring of the course of pregnancy in a hospital or emergency medical intervention is necessary. A pregnant woman diagnosed with acute fetal hypoxia should be hospitalized in a maternity hospital. In the hospital, a woman is being prepared for an emergency caesarean section in order to save the life of a child with hypoxia. Since prolonged oxygen deprivation can result in brain cell death, leading to fetal asphyxia, there is usually very little time in this situation. The severity of the consequences of this type of pathological changes is assessed by obstetricians using a special Apgar system immediately after delivery in the delivery room.

Who is at risk?

Fetal hypoxia can be caused by provoking factors of other diseases or pathologies:

• severe early or late toxicosis;
• anemia of the hands and feet;
• threats of termination of pregnancy;
• respiratory diseases;
• the presence of various infections of the genitourinary system;
• endocrine diseases (for example: thyroid diseases and diabetes mellitus);
• violations of the functioning of the cardiovascular system (heart disease, abnormal pressure, vegetovascular dystonia);
• incompatibility in mother and father of blood group and Rh factor;
• too early or late age of the pregnant woman;
• consumption of alcoholic beverages by a pregnant woman, etc.;
• wrong lifestyle of the expectant mother.

Diagnosis of fetal hypoxia

Diagnosis is carried out through the assessment of the condition of the fetus. Due to the different significance of the methods, it is important to conduct a comprehensive form of research. Such an actual method as auscultation allows you to listen to the fetal heartbeat through the use of a stethoscope - a special tube made of metal, designed to determine the sounds coming from the heart and other organs. The doctor's task is to assess the speed and nature of heart contractions, to determine the sonority of heart tones.

However, according to modern experts in the field of medicine, the auscultatory method has a dubious accuracy of its results. Since the calculation of heart contractions in the fetus may be erroneous by 10-15 beats / min. Based on the heart rate, you can find out how the fetus is located in the uterus, whether there are still fruits there. The baby's heart can be easily heard through the mother's belly in the second trimester of pregnancy.

The method of cardiotocography (CTG) is used in the process of diagnosing fetal hypoxic conditions. Its implementation is possible using an ultrasonic sensor that is installed on the pregnant woman's abdomen at special points for maximum audibility of the heartbeat. Recording of heartbeats during KGT is made on paper. Important elements of diagnostics are the answers to the following questions: how many heart contractions, how fast and slow heart contractions are (the first are called accelerations, the second - decelerations).

The appearance of both the first and the second may be due to contractions, movements of the child, or an increase in uterine tone. An indicator of the normal state of the baby in the womb is the occurrence of acceleration in response to the movement of the child or an increase in uterine tone (at least five in 30 minutes). Only single forms of decelerations can be allowed, which normally should not be at all or should be minimal.

A non-stress test (NST), which measures only acceleration, can be performed within the described method. When using this method, acceleration appears as a reaction to spontaneous uterine contractions or spontaneous fetal movements. Such a test can be considered accurate with a probability of 99%. Tension and exhaustion of the reactions of adaptation and adaptation of the fetus can be recorded with non-reactive NST.

For data reliability, they should be combined with the definition of BFP (fetal biophysical profile). To this end, five components were developed:

1. movements of the child's respiratory system
2. large movements of the child's torso
3. amniotic fluid volume
4. non-stress test
5. child's muscle tone.

For diagnostics, dopplerometry is also used, which is a study that analyzes the effectiveness of blood flow in the vessels of the fetus, umbilical cord and uterus. The severity of fetal hypoxia depends on the violations, due to which it can be planned how the pregnancy will continue, and how the birth will take place. A good effect is such a diagnostic method as an ECG of the fetus, as well as a blood test of the mother. Also important is the content of fat-oxidizing products in the blood, a number of enzymes, acid-base blood balance in a pregnant woman and in the umbilical cord.

CTG is prescribed when a doctor suspects pathological changes. When it is performed, a sensor is used to record the fetal heartbeat. For an accurate understanding of the state in which the unborn child is, the specialist makes a transcript. CTG is a diagnostic option used both during pregnancy and as a planned procedure during childbirth.

Ultrasound plays an important role. Attention is also focused on the maternal placenta. Evidence of hypoxia can be its various pathological changes. A woman with symptoms of fetal hypoxia should undergo a preventive examination in the inpatient department.

Treatment of chronic fetal hypoxia

Fetal hypoxia should be treated in a complex form (composed of several parts). It is necessary to treat the disease that led to the lack of oxygen in the child. Also, in order to normalize the blood flow of the placenta, certain therapeutic procedures should be carried out. Bed rest helps to improve the blood flow of the uterus, so a pregnant woman must comply with it.

You can reduce the contractility of the uterus with the help of certain medicines prescribed by doctors:

• (given intravenously)
• Bricanila

Complex therapy also consists of a method to reduce blood viscosity. Thanks to this, the tendency to form blood clots can be reduced, as well as blood circulation in small vessels is restored. The effect is guaranteed when using the following drugs:

1. Reopoliglyukina (endocrine and hormonal drugs)
2. Curantyl (prevents platelets from sticking together and forming blood clots)
3. Aspirin at extremely low doses

Treatment of the chronic form of the disease can be done through the use of Lipostabil or Essentiale Forte, which favorably affects the passage of oxygen to the cells. Specialists can also prescribe medications that will improve cell metabolism:

• used to strengthen blood vessels
• ascorbic acid, which allows the normal functioning of the connective and bone tissue
• glucose solutions, easily digestible food sources
• glutamic acid, well absorbed when taken orally

A pregnant woman is prescribed emergency delivery if the complex treatment of fetal hypoxia has not brought positive results.

It must be borne in mind that while observing bed rest, the mother needs to take the “crocodile pose” - on the left side. Treatment is also carried out with the use of oxygen therapy.

Doctors prescribe the introduction of 500 milliliters of a 10% glucose solution intravenously + 10 units of insulin + 100 milligrams of cocarboxylase + 10 milliliters of 5% ascorbic acid. Such infusions are carried out for five to eight days.

Drugs such as sigetin (2 milliliters - 1%), Eufillin (10 milliliters - 2.4%), Curantil (2 milliliters - 0.5%), ATP (2 milliliters - 1%) help improve blood circulation between the uterus and the placenta. ). The introduction of Reopoliklyukin is carried out by 200 milliliters by drip intravenously. With premature pregnancy and increased uterine excitability, as well as in other cases, tocolytics bring a certain effect. 25% in a 5% glucose solution 10 milliliters or Alupent (0.5 milligrams) in a 5% glucose solution is injected intravenously by drip. After passing a 2-6-day course, the administration of the drug continues intramuscularly or is treated with tablets.

Treatment of acute fetal hypoxia

It has already been noted that the expectant mother needs to be in the “left” position. The use of prolonged inhalations of pure humidified oxygen through a well-fortified mask is recommended. Glucose, insulin, ascorbic acid solution and Cocarboxylase are administered intravenously.

A 2.4% solution of Eufillin is slowly injected intravenously in a 10-milliliter amount + 2 milliliters of 1% Sigetin, as well as ATP (2 milliliters - 1%). Also, the administration of 10 milliliters of a 10% solution of calcium gluconate intravenously or the administration of 5% sodium bicarbonate in an amount of 60-80 milliliters by drip is sometimes prescribed.

With the sudden development of fetal bradycardia, a pregnant woman is given 0.3% milliliter IV or 0.7 milliliters s / c of a 0.1% solution of atropine sulfate. If there is access to the presenting part, atropine sulfate (0.1 milliliter - 0.1%) must be administered subcutaneously to the fetus. With the ineffectiveness of the above methods of treatment, the pregnant woman is prepared for premature birth.

Fetal hypoxia during childbirth: features and treatment

The obligations of the obstetrician during delivery include listening to the baby's heartbeat. Symptoms on the basis of which fetal hypoxia is diagnosed are fetal tachycardia and bradycardia. Also, the doctor should be wary of muffled tones and arrhythmias in the heart rhythm. It is necessary to take into account the difference in the degree of tachycardia and bradycardia in different periods of labor. Bradycardia at the first stage of the development of hypoxia is 100 beats / min, at the second stage - already 98 beats / min.

Ingestion of amniotic fluid and blood by the baby is the main consequence of hypoxia during childbirth. This fact leads to a violation of the functioning of the respiratory system in a child. Fetal hypoxia during childbirth is most often recorded in premature babies, with too prolonged labor, with the appearance of bleeding, when various infections enter the baby's body. Asphyxia is suffocation that appears during severe starvation from a lack of oxygen, in which oxygen almost completely stops flowing to the baby. Usually, its occurrence is due to premature detachment of the placenta, repeated entanglement of the baby with the umbilical cord, infringement of the umbilical cord and other factors.

After the baby is born, he receives oxygen from the air. But how does he get it when he is in the womb? All the necessary substances, including oxygen, he receives from the mother's body.

Through the placenta, the baby receives oxygen, which from the mother's blood enters the blood of the fetus. But, if there is not enough oxygen in the mother's blood, then the baby will not have enough of it. And then a pregnant woman can be given an unpleasant diagnosis - fetal hypoxia.

What is fetal hypoxia?

As a rule, oxygen deficiency occurs during the period and is associated with various problems. The most common of them are or chronic diseases of the mother.

It develops under the influence of many disorders of the process and pregnancy.

Slight hypoxia will not affect the life and health of the unborn baby in any way. However in severe disease, which is accompanied by ischemia and necrosis of internal organs, there are irreversible consequences for the health of the fetus.

Oxygen starvation occurs due to various processes in the body of the mother, fetus or placenta. Hypoxia is chronic and acute.

Acute hypoxia develops suddenly, and chronic - over a long period of time. Acute hypoxia, as a rule, occurs already at childbirth, and during pregnancy it is extremely rare.

Chronic can develop throughout pregnancy.

Symptoms

This pathology can be diagnosed palpitations in the early stages of pregnancy and slow - in the later. In addition, heart sounds are muffled.

Besides fetal stool appears which is called meconium in amniotic fluid.

If a pregnant woman has a mild form of fetal hypoxia, then she may feel that the baby has begun to move much more actively.

In case of severe his movements, on the contrary, become slower and occur less frequently.

So, if you have a suspicion that you have this ailment, then keep a movement diary.

If their frequency is less than 10 per hour, then you should contact your gynecologist to prescribe further tests.

signs

The detection of this pathology is almost impossible. However, it may be suspected based on maternal anemia or other medical conditions.

In the middle of pregnancy when the baby's movements are most active, hypoxia can be suspected if their frequency decreases. For more sluggish and infrequent movements, contact your doctor.

In addition to your own feelings, this diagnosis can be made on the basis of examinations:

1. If, according to the results of an ultrasound examination, the size and weight of the fetus is less than normal, and there is also a delay in its development.
2. If dopplerometry shows poor blood flow in the placenta, uterine arteries, or there is a suspicion of a reduced fetal heart rate.
3. In the third trimester of pregnancy, the condition of the fetus is estimated at 8 and below. However, this indicator often shows hypoxia when it is not present. So if you suspect this disease, you should redo the test in a few days.
4. In some cases, amnioscopy is performed and blood is taken during childbirth from the skin of the baby's head.
5. The presence of fetal hypoxia during childbirth can be indicated by the color of the amniotic fluid. In such a case, they become cloudy green in color, in some cases containing meconium. There is no hypoxia during childbirth if the waters are clear.

Causes

Oxygen starvation is not an independent disease are the result of various factors. These factors may come from the mother, the fetus or the wrong course of pregnancy.

Causes maternal chronic hypoxia most often are:

• kidney disease or toxic damage;
• pregnant;
• intoxication;
• diseases of the cardiovascular system or lungs;
• maternal smoking during pregnancy;
• unfavorable working conditions.

Among the main complications course of pregnancy, which causes hypoxia, can be distinguished:

• preeclampsia;
• or ;
• insufficient uteroplacental blood flow;
• diseases of the placenta;
• incorrect presentation;
• pregnancy.

Chronic hypoxia can also be caused by diseases of the fetus itself.. The most common of them:

• hemolytic disease, especially in severe form;
• congenital malformations;
• fetal anemia;
• infections.

Causes of acute hypoxia are:

• placental abruption;
• rapid childbirth;
• squeezing the head during childbirth;
• anesthesia given to a woman in labor during childbirth;
• weak labor activity.

Forms of the disease

Fetal hypoxia may be acute, subacute and chronic.

acute form may occur during pregnancy or childbirth. In the first case, it occurs due to rupture of the uterus or premature detachment of the placenta. In the second - with abnormal labor activity or clamping of the umbilical cord.

Subacute hypoxia occurs a few days before delivery.

Chronic hypoxia occurs with a complication of pregnancy or diseases of the mother or unborn baby. Due to a prolonged lack of nutrients and oxygen, as a rule, there is a delay in the development of the fetus and its insufficient size.

The danger of hypoxia for the fetus and its consequences

At different stages of pregnancy, hypoxia can cause various disorders and pathologies of fetal development.

In the first trimester during the formation of the fetus and its internal organs, hypoxia can cause developmental pathologies.

In late pregnancy due to oxygen starvation, the fetus may have a developmental delay, insufficient size and weight, as well as damage to the central nervous system.

Hypoxia during childbirth can cause asphyxia and severe disorders of the central nervous system of the crumbs. That is why, if hypoxia occurs during childbirth, it is recommended to carry out.

Diagnosis and treatment of the disease

When acute oxygen starvation occurs fetus during childbirth is necessary to carry out an emergency caesarean section. When opening the cervix, forceps are applied.

If it's about chronic hypoxia that occurred during pregnancy, then during childbirth, the mother is injected with glucose, ascorbic acid and antispasmodics, as well as oxygen therapy.

In chronic hypoxia, some doctors recommend do not treat this condition, but monitor the condition of the fetus. In this case, with a strong deterioration in the situation, an emergency caesarean section should be performed.

• appoint a pregnant woman bed rest, which improves blood circulation in the uterine cavity;
• prescribe drugs that improve metabolism, capillary blood supply, as well as placental blood flow. In addition, it is mandatory to use drugs that increase the permeability of cells to oxygen;
• treatment of diseases that caused hypoxia;
• drugs that reduce uterine contractions;
• if the condition of the unborn baby worsens, then a caesarean section should be performed after the 28th week.

Disease prevention

A pregnant woman and her doctor should monitor the course of pregnancy very carefully. Thus, it will be possible to determine fetal hypoxia as early as possible.

Oxygen starvation occurs due to diseases of the pregnant woman or fetus. So it is most important to conduct an early diagnosis of the pregnant woman and the fetus.

Besides it is important that the expectant mother not only during pregnancy, but also before it, she monitored her health, nutrition, led a healthy lifestyle and experienced sufficient physical activity.

Throughout the pregnancy, a woman must walk outdoors as much as possible. This rule will allow a pregnant woman not only to prevent certain possible complications of pregnancy, including oxygen starvation of the fetus.

The supply of oxygen to the body provides better metabolism in the placenta and reduces the likelihood of oxygen starvation of the fetus.

Beyond prevention with the help of walks in the fresh air, a mild degree of hypoxia can also be treated. Because no oxygen cocktails can replace a few hours in the fresh air.

If the expectant mother does not have or, then go swimming or aqua gymnastics.

The normal course of pregnancy can greatly complicate the diagnosis, which sounds threatening to the expectant mother - “fetal hypoxia”. According to statistics, every third pregnant woman faces such a problem to one degree or another. Why a child begins to suffer from a lack of oxygen and how dangerous it is for his health, we will tell in this article.

What it is?

Fetal hypoxia is a state of oxygen starvation in which the child suffers quite severely. Most expectant mothers have chronic hypoxia, in which the lack of oxygen in the baby lasts for quite a long time. Sometimes the condition is acute, and this is very dangerous for the fetus, as it can lead to the death of the child in utero from asphyxia.

With an insufficient level of oxygen, which the baby receives through the bloodstream for all 9 months, serious changes occur in his body - the metabolism changes, pathological changes in the nervous system of the crumbs are observed.

If the hypoxia is insignificant, the baby is quite capable of coping with this condition with little or no consequences for himself, since the compensatory mechanisms even in an unborn baby are incredibly large. So, the baby “stores” oxygen in advance, since the number of O2 molecules in his blood is much higher than in the blood of an adult, so when starvation sets in, he will be able to consume his own reserves for some time. In addition, the adrenal glands react quickly to the lack of oxygen in the baby, which immediately in response produce hormones that allow for a while to increase blood pressure and normalize the heart rate.

Despite all this, unfortunately, these mechanisms are not able to compensate for prolonged hypoxia or acute fetal hypoxia. When a gynecologist who observes a future mother talks about the presence of fetal hypoxia, he will definitely specify what degree of the problem he is talking about. 1 degree - insignificant, the second and third may be the basis for hospitalization of a pregnant woman or premature delivery if the baby's condition is threatening.

The lack of oxygen during pregnancy is usually chronic.

Acute hypoxia most often develops during childbirth. It is provoked by incorrect actions of medical personnel - stimulation of contractions with strong medications, aggressive acceleration of the birth process.

Doctors can already predict the possible consequences for the child in the delivery room, since the condition of the baby immediately after birth speaks volumes. Depending on him, he is given the first grades in his life - points on the Apgar scale, this assessment system necessarily includes an assessment of the post-hypoxic state. The lower the score, the more serious the problems may be in the future. A child born with acute hypoxia is characterized by low scores in the first 10 minutes after birth, but after an hour the child can safely be given 7-8 Apgar points. In this case, the forecasts are positive. If the baby's condition does not improve or begins to worsen, the prognosis is not so rosy.

Causes

Chronic hypoxia can occur for a number of reasons:

• maternal diabetes;
• viral infection in the first trimester of pregnancy;
• pregnancy with twins or triplets;
• prolonged state of threatened abortion, threatened miscarriage;
• partial placental abruption, spotting;
• post-term pregnancy (more than 40 weeks);
• anemia pregnant;
• violation of uteroplacental blood flow;
• bad habits - smoking during pregnancy, alcohol, drugs.

Acute hypoxia occurs in cases of complications in childbirth with:

• entwining the baby with the umbilical cord with clamping the umbilical cord ring;
• polyhydramnios;
• twin or triplet pregnancies;
• premature detachment of the placenta, which often occurs with rapid, rapid labor or in labor that is stimulated by piercing the fetal bladder or medication;
• primary or secondary weakness of ancestral forces.

Diagnostics

Diagnosis of fetal hypoxia is not an easy task, because babies behave differently in the womb. One is lazy due to temperament and rarely moves, the other is active, and his frequent movements are often taken by both women and doctors as a manifestation of hypoxia. Some symptoms should alert:

• a change in the nature of the motor activity of the fetus, in which at first the baby moves chaotically and often with strong painful shocks, and then, as oxygen starvation develops, the movements become more and more rare;
• the height of the bottom of the uterus is significantly lower than normal;
• the child develops with a noticeable lag (fetometric indicators are below the lower limit of the norm);
• a pregnant woman is diagnosed with oligohydramnios.

In late pregnancy, doctors advise to monitor the baby's movements especially carefully, the number of movements should be recorded in a diary.

Normally, an awake baby should make up to 10 movements per hour. These can be coups, easily perceptible and distinguishable, and barely noticeable movements. It is recommended to register movements from 20-22 weeks of pregnancy until its completion.

If the doctor, on the basis of the deviations from the norms described above, suspects hypoxia, he will definitely prescribe a CTG to the pregnant woman. During cardiotocography, sensors attached to the abdomen will record all the movements of the baby, a change in his heart rate, even hiccups will be reflected. Additional research methods include doplerometry, fetal ECG, and ultrasound (this differs from the standard ultrasound procedure in that the doctor will not look at parts of the child’s body, but at the blood flow velocity in the uterine arteries, in the umbilical cord). An extended blood test from the mother's vein, in addition to the methods listed, allows you to determine whether there is enough hemoglobin in the blood and clarify other biochemical factors.

Acute birth hypoxia does not need extended diagnostics, since the real-time fetal monitor immediately registers the pathological state of oxygen starvation in the child as soon as it occurs.

The most reliable sign is bradycardia - a decrease in heart rate in a baby who has not yet had time to be born. If the normal fetal heart rate is from 120 to 170 beats per minute, then in a baby who suffers oxygen starvation, the heart rate will be at the level of 80-90 beats per minute. Tachycardia can also be said about the lack of oxygen if the child's heart rate is above 180-190 beats per minute.

The amniotic fluid in which the child with chronic hypoxia was located is sometimes dark or dark green in color, with an unpleasant smell of meconium (the original feces of a newborn). The baby himself after birth will be weaker than other babies, he will have reduced or increased muscle tone, neurological disorders of varying severity.

Possible consequences

The most formidable, but, alas, absolutely real consequence of oxygen starvation is brain hypoxia. It is the brain that suffers from hypoxia more often and more strongly than other organs. Even the most experienced doctor will not undertake to predict what disorders will cause dysfunction of one or another part of the brain in the perinatal period. However, after childbirth, it is quite possible to assess the traumatic impact. And if some disorders, such as problems with speech development, become apparent later, then gross hypoxic-ischemic lesions of the central nervous system in most cases can be diagnosed even in the maternity hospital, in extreme cases - in the very first months of a baby's life.

The consequences for the nervous system due to brain cells dying during oxygen deficiency can be different - from moderate hyperactivity of the child in the future to severe lesions, which include cerebral palsy, paresis of various dislocations. In complicated childbirth in a state of acute hypoxia, cerebral hemorrhage, ischemia, and cerebral edema often occur. The damage that occurs with such violations can be total and irreversible.

Both acute and chronic oxygen deficiency can lead to a wide variety of diseases, mainly of a neurological nature. So, problems with vision or hearing are a fairly common posthypoxic consequence. If hypoxia was prolonged, then the child may have underdevelopment or abnormal development of some internal organs, heart defects, kidneys, and so on. Minor neurological disorders in most cases, the child manages to "outgrow" by the age of 6-7, of course, with constant monitoring by a neurologist and the implementation of all his recommendations.

In general, the prognosis with regard to possible consequences directly depends on how early hypoxia was detected and how quickly treatment was provided. That is why women are not recommended to miss the next consultation appointment, and ladies with chronic diseases have to visit an obstetrician two to three times more often.

Treatment during pregnancy

The established fact of hypoxia during pregnancy should in no case be ignored; fast and effective therapy is needed to minimize the possible consequences for the baby. Doctors urge expectant mothers, first of all, to calm down, since excessive nervous experiences only aggravate the already rather difficult condition of the child.

In the later stages, severe hypoxia may be an indication for urgent delivery by caesarean section. At earlier dates, when the baby is still very early to be born, doctors will try to do everything possible to make the baby feel better. Treatment can be done at home, but on condition that the severity of hypoxia does not exceed 1 degree. The remaining cases are subject to urgent hospitalization and constant monitoring of the pregnant woman and the baby in the hospital.

Doctors prescribe bed rest for mothers, it is with it that the blood supply to the placenta increases and minor hypoxia can be cured as soon as possible. The main approach to drug therapy is the use of drugs that improve uteroplacental blood flow, such as Curantil, Actovegin. In severe hypoxia, these drugs are administered intravenously by drip. In other situations, it is allowed to take pills. A woman is prescribed vitamins, iron, magnesium preparations. Treatment courses are repeated.

If a woman has an underlying disease, which, presumably, caused oxygen deficiency, then treatment should include therapy for this disease.

Two specialists take part in this - an obstetrician-gynecologist, who knows what is possible and what is impossible for his patient in an “interesting” position, and a specialist doctor who is in charge of the disease. They should prescribe medications and manipulations together, the treatment, as it was before pregnancy, usually changes.

A child who has experienced acute birth hypoxia, in the very first hours after birth, will receive powerful vascular therapy, he will also be given sedatives, vitamins, especially group B. A neurologist will observe the baby from the first hours of his independent life.

Treatment after birth

Without exception, all children who experienced hypoxia during their intrauterine existence are shown special observation by a pediatric neurologist. Almost always, such babies, regardless of the consequences, are put on dispensary records. In the overwhelming majority of cases, they are recommended therapeutic massage from the very first days, taking vitamins, water procedures with the use of soothing decoctions of medicinal herbs. Many babies after 3-4 years of age require speech therapy to overcome probable problems with speech development and pronunciation.

The rest of the treatment depends only on what posthypoxic diagnosis was established, because with cerebral palsy one approach and the choice of medications are required, and with a pathological decrease in hearing or vision, it is completely different. Cerebral palsy is considered to be the most difficult in treatment, and increased muscle tone without other neurological symptoms is the most easily corrected. Parents should prepare for a rather lengthy treatment, since post-hypoxic consequences that are subject to correction take years to eliminate.

You can find out some more information about fetal hypoxia in the next video.

What is fetal hypoxia

While the baby is in the uterus, his lungs are not yet working. They are filled with fluid, and although they sometimes make respiratory movements, oxygen does not flow through them.

The only source of oxygen for the baby is the placenta, and she, in turn, receives it from the mother's blood. If at any stage its supply is disturbed, oxygen starvation of the fetus develops, or hypoxia.

Fetal hypoxia during pregnancy

The time of onset of hypoxia, as well as its duration, play a very important role in the future of the baby. The sooner and longer, the worse. In the early stages, hypoxia can cause abnormalities in the development of organs, including the baby's brain, and lead to neurological problems in the future.

In late pregnancy, hypoxia is also unsafe. It does not allow the baby to develop correctly and in time, causes intrauterine growth retardation. Severe hypoxia in the later stages may lead to the need for an early caesarean section.

Hypoxia in childbirth

In addition to the time of pregnancy, dangerous hypoxia can begin during childbirth, then it is called acute. Normally, all children at birth experience a moderate lack of oxygen and are quite well adapted to temporary hypoxia.

However, in some cases, labor hypoxia can be dangerous: in premature babies, with prolonged labor, with bleeding or infection.

Severe hypoxia with an almost complete cessation of oxygen supply is called fetal asphyxia. Asphyxia is practically suffocation. It can develop only as a result of complications: premature detachment of the placenta, multiple entanglement of the umbilical cord, strangulation of the umbilical cord, and some others.

Possible causes of hypoxia

From the mother's side:

• Low - less than 120g / l - blood hemoglobin (anemia);
• Bronchitis, asthma and other lung diseases;
• smoking during pregnancy;
• kidney disease;
• Diabetes and others.

From the side of the fetus:

• Congenital malformations;
• Intrauterine infections;
• Fetoplacental insufficiency;

During childbirth:

• Incorrect presentation of the fetus (pelvic, oblique);
• Multiple births (twins, triplets);
• Prolapse of the umbilical cord;
• and others.

Signs of fetal hypoxia, how to determine fetal hypoxia?

In the early stages, it is almost impossible to reliably detect hypoxia, it can only be assumed if the mother has anemia or another disease.

After 18–20 weeks, when the baby begins to move with might and main in the uterus, the mother may suspect hypoxia by reducing its activity. If the movements of the fetus have become sluggish and more rare, it is necessary to see a doctor for an examination.

Signs of hypoxia during examination:

• On - a delay in the development of the fetus, that is, its size and weight are less than normal for a given period;
• On: deterioration of blood flow in the placenta, in the uterine arteries, a decrease in the fetal heart rate (bradycardia);
• On CTG (after 30 weeks): a total score of 8 or less, a fetal condition index (PSP) of more than 1, a decrease in basal heart rate less than 110 at rest and less than 130 during movements, etc. CTG tends to give many false positive results, that is, to identify hypoxia where there is none. In the case of a bad analysis, most often you just need to redo it the next day.

In difficult cases, other diagnostic methods are also used, such as amnioscopy and blood sampling from the skin of the fetal head (only in childbirth).

During childbirth, the presence of hypoxia can be judged by the color of the amniotic fluid. If the waters are cloudy, greenish in color, and even worse - with an admixture of meconium, then the baby is already experiencing a lack of oxygen. Transparent amniotic fluid is a sign of good blood supply and the condition of the baby.

How to deal with hypoxia

Throughout pregnancy, it is very important for all expectant mothers to walk in the fresh air as much as possible. This simple rule will help you prevent many pregnancy complications, including fetal hypoxia.

A sufficient supply of oxygen from the inhaled air ensures a good metabolism in the placenta and reduces the likelihood of hypoxia. But in addition to prevention, walking can and should be used to treat mild hypoxia. No oxygen cocktails can replace 3-4 hours spent outdoors.

If there is no threat of miscarriage or increased uterine tone, it is useful to do aqua gymnastics and swimming.

In more serious cases, at the decision of the doctor, hospitalization in the maternity hospital and treatment with medicines are necessary. For this apply:

• Curantyl
• Actovegin
• Trental
• Oxygen cocktail

and other means, depending on concomitant diseases. For example, with an increased tone of the uterus, magnesia, no-shpu, ginipral, etc. are prescribed.

Severe hypoxia at the end of pregnancy may sometimes require a caesarean section. Children born with acute hypoxia or asphyxia often require resuscitation and longer care.

In this article:

What is fetal hypoxia?

It happens that during pregnancy and childbirth, the tissues and organs of the fetus are not sufficiently supplied with oxygen. This pathology can develop gradually or appear suddenly. So they share chronic and acute fetal hypoxia - a condition more often characteristic of childbirth, when the normal course of the process is disturbed.

Pathology can occur both in early pregnancy and later. Regardless of the time of manifestation of such a condition, the consequences of oxygen deficiency are always unfavorable for the unborn child. Intrauterine hypoxia of the fetus that occurred in the early stages can lead to developmental abnormalities.

The manifestation of hypoxia at a later date slows down the growth of the fetus, can cause disorders of the central nervous system and, in the future, manifest itself in a significant deterioration in the adaptive capabilities of the child.

It should be remembered that a slight, short-term hypoxia, most likely, will not adversely affect the health of the unborn baby. But prolonged or severe oxygen starvation can lead to irreversible consequences.

In order to prevent the development of pathology, one should know about the causes of hypoxia, the signs of a violation, and methods for preventing such a condition.

Causes of hypoxia

Oxygen starvation is manifested as a result of unfavorable processes in the body of a pregnant woman or fetus. There are a sufficient number of factors contributing to the development of hypoxia. First of all, these are various diseases of the future mother (for example, disorders of the cardiovascular system, intoxication, anemia, etc.), as well as disruptions in the normal functioning of the placental blood flow, for example, due to preeclampsia, overmaturity, pathologies of the umbilical cord and placenta. Fetal diseases, for example, such as anemia, malformations, can also cause hypoxia.

Much is known about the mechanisms of the development of pathology: hypoxia is caused by disturbances in the supply of oxygen to the uterus and metabolic processes of the placenta, hemoglobin deficiency, and manifestations of cardiovascular insufficiency.

Some doctors, talking about the occurrence of fetal hypoxia, find the causes in genetic problems. But, most often, the manifestation of such a pathology is still not hereditary, but acquired.

Some diseases of the expectant mother, which she suffered shortly before pregnancy or during the period of bearing a child, can lead to hypoxia.

Among these diseases are:

• intoxication of the body due to poisoning, toxicosis, harmful working conditions or functional disorders in the kidneys;
• diseases or pathology of the development of the lungs;
• heart failure;
• anemia
• diabetes.

Also, some complications during pregnancy can lead to a pathological condition:

• (increased amount of amniotic fluid);
• toxicosis in the last months of pregnancy -;
• malfunctions of the placenta or uteroplacental blood flow.

Sometimes hypoxia is manifested due to infection of the fetus, congenital malformations, the occurrence of anemia, or incompatibility of the blood of the mother and child (hemolytic disease).

Acute hypoxia can be the result of premature placental abruption, uterine ruptures, more often in the last stages of pregnancy, or an abnormal course of labor (prolonged or rapid process), careless squeezing of the fetal head by a woman in labor, prolapse or pressing of the umbilical cord.

signs

It is important not to miss the first signs of intrauterine fetal hypoxia. Indeed, in most cases, timely measures taken to avoid the negative consequences that will invariably manifest themselves during prolonged oxygen starvation.

The first and main sign of acute hypoxia is a violation of the fetal heart, which is characterized by an uneven heartbeat (arrhythmia), an increase or slowdown in heart rate, and deafness of tones.

Normally, until the moment of birth, the baby's heartbeat is quite frequent - 110-160 beats per minute. A more intense heartbeat (over 160 beats) and slow (below 80 beats per minute) can be considered symptoms of hypoxia.

Another sign, which in some cases can indirectly tell the pregnant woman about the presence of problems in the unborn child, is a change in the habitual motor activity of the fetus. With slight oxygen starvation, his behavior becomes restless, the movements become more frequent and strong. If the condition of the unborn child does not improve and hypoxia progresses, fetal movements become weaker. It is believed that during the normal course of pregnancy, a woman should feel fetal movements at least 3 times within one hour. However, before making hasty conclusions about the occurrence of hypoxia and calling a doctor, you should independently observe the movements of the unborn child for several hours.

At the disposal of modern medicine there are many research methods that, with varying accuracy, allow us to confirm or refute the presence of oxygen deficiency, to determine the degree of danger to the fetus. Among the methods used, the most accurate and informative CTG (cardiotachography), phonocardiography, dopplerometry, amniotic fluid examination (amnioscopy) can be distinguished.

The possibilities of ultrasound scanning are also widely used, thanks to which it is possible to identify uneven respiratory movements made by the fetus, characteristic of hypoxia.

With proper management of childbirth, doctors monitor the well-being of the fetus with the help of cardiac monitoring. There are other signs by which one can judge the troubles of a child who is born. One of the signs of acute oxygen starvation is green waters stained with meconium.

Consequences for the child

The consequences of fetal hypoxia that occurred during pregnancy can be different: in some cases, oxygen deficiency does not affect the health of the unborn child, but much more often, it still leads to serious consequences.

It is unacceptable to assume that hypoxia does not require attention, and the improvement of an unfavorable state will come by itself! The longer and more intense the oxygen starvation, the stronger the changes occurring in the body of the unborn child.

Lack of oxygen leads to serious disruption of the circulatory and microcirculation systems. Due to chronic intrauterine hypoxia in the fetus, blood thickens, tissue edema develops, and increased vascular permeability leads to hemorrhages. Under the influence of oxygen deficiency, the balance of electrolytes in the body of an unborn child is disturbed, oxidation products of organic acids accumulate in the tissues, which leads to intracellular edema. All these changes upset the work of the most important organs, which can cause fetal death or serious asphyxia of the newborn.

Manifestations of hypoxia in the first trimester of pregnancy can cause disorders in the development of the brain in the fetus.

Prevention

Prevention of fetal hypoxia consists in regular medical supervision of a woman throughout pregnancy. Timely diagnosis and timely treatment are of great importance for the health of the child. Identification of complications of pregnancy, monitoring the condition of the fetus is the doctor's task. The future mother should lead a correct lifestyle, give up harmful or dangerous work, try to avoid unrest.

Prevention of fetal hypoxia during childbirth, first of all, depends on the competent actions of the doctor: the correct choice of the method of delivery, constant monitoring of the condition of the woman and child, and a quick response to emerging complications.

A woman in labor should master a special breathing technique in advance and apply the acquired skills in practice at the right time. Controlling her own breathing helps a woman get enough oxygen in labor, which has a positive effect on the condition of a child ready to be born.

Methods for the treatment of fetal hypoxia

In the treatment of chronic fetal hypoxia, the knowledge and experience of the doctor, as well as the correct attitude and discipline of the expectant mother, are important. One dose of prescribed medications is usually not enough. Often a woman has to reconsider her own lifestyle during pregnancy, making a choice in favor of a relaxing holiday. Sometimes for the health of the baby, you need to take bed rest, which helps improve the blood supply to the uterus.

Often, if hypoxia is suspected, the doctor decides to hospitalize the pregnant woman for a more detailed study of the condition of the fetus, to identify the prerequisites for the manifestation of pathology.

Treatment of fetal hypoxia begins with a search for the cause - a disease that led to the development of oxygen deficiency. At the same time, therapy is carried out aimed at normalizing metabolic processes and improving the supply of oxygen to the unborn child.

In drug therapy, drugs are prescribed that reduce the activity of the uterus (Papaverine, No-shpa, Ginipral).

Treatment is also carried out, the purpose of which is to reduce blood viscosity. If the therapy is successful, the pregnant woman is less likely to form blood clots, blood flow is restored in small vessels. For these purposes, the drug Curantil is prescribed.

In chronic fetal hypoxia, it is necessary to improve metabolism (vitamin E, glucose solution, etc.) and cell permeability (Essentiale Forte, etc.)

In the event that complex therapy does not bring the desired effect and the condition of the fetus worsens, while the gestational age exceeds 28 weeks, the issue of emergency delivery by caesarean section is resolved.

Acute hypoxia is a direct indication for urgent hospitalization. During transportation, doctors carry out a set of measures aimed at maintaining a stable state of the fetus.

conclusions

Hypoxia can be dangerous to the health and life of the unborn child. Throughout pregnancy, a woman should closely monitor her own health and regularly visit an obstetrician-gynecologist. You should carefully consider the choice of a competent specialist, whose knowledge and experience will help prevent undesirable consequences in the event of a pathology.

If possible, a pregnant woman should avoid stressful situations. Strong unrest does not have the best effect on the health of the expectant mother and affects the development of the fetus.

Calmness, attention to yourself and a positive attitude will help to cope with the manifestations of hypoxia during pregnancy and give birth to a healthy baby.

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