Oxygen starvation of the fetus during pregnancy. Oxygen starvation of the fetus during pregnancy

- intrauterine syndrome, characterized by a complex of changes in the fetus, due to insufficient oxygen supply to its tissues and organs. Fetal hypoxia is characterized by disorders of the vital organs, primarily the central nervous system. Diagnosis of fetal hypoxia includes cardiotocography, dopplerometry of uteroplacental circulation, obstetric ultrasound, amnioscopy. Treatment of fetal hypoxia is aimed at normalizing uteroplacental blood flow, improving blood rheology; sometimes this condition requires early delivery of a woman.

Taking into account the compensatory-adaptive capabilities of the fetus, hypoxia can acquire compensated, subcompensated and decompensated forms. Since, under adverse conditions, the fetus experiences not only hypoxia, but also a whole complex of complex metabolic disorders, in world practice this condition is defined as a “distress syndrome”, which is divided into prenatal, developed during childbirth and respiratory.

Manifestations of fetal hypoxia

The severity of the changes that develop in the fetus under the influence of hypoxia is determined by the intensity and duration of the oxygen deficiency experienced. The initial manifestations of hypoxia cause an increase in the heart rate in the fetus, then its slowdown and muffled heart sounds. Meconium may appear in the amniotic fluid. With mild hypoxia, the motor activity of the fetus increases, with severe hypoxia, movements slow down and slow down.

With severe hypoxia, the fetus develops circulatory disorders: there is a short-term tachycardia and an increase in blood pressure, followed by bradycardia and a decrease in blood pressure. Rheological disorders are manifested by thickening of the blood and the release of plasma from the vascular bed, which is accompanied by intracellular and tissue edema. As a result of increased fragility and permeability of the vascular walls, hemorrhages occur. A decrease in vascular tone and slowing of blood circulation leads to ischemia of organs. With hypoxia, acidosis develops in the fetal body, the balance of electrolytes changes, and tissue respiration is disturbed. Changes in the vital organs of the fetus can cause intrauterine death, asphyxia, intracranial birth trauma.

Diagnosis of fetal hypoxia

The suspicion that the fetus is experiencing hypoxia may arise when its motor activity changes - restless behavior, increased and more frequent movements. Prolonged or progressive hypoxia leads to a weakening of fetal movements. If a woman notices such changes, she should immediately contact the gynecologist who manages the pregnancy. When listening to the fetal heartbeat with an obstetric stethoscope, the doctor evaluates the frequency, sonority and rhythm of heart sounds, the presence of noise. To detect fetal hypoxia, modern gynecology uses cardiotocography, fetal phonocardiography, dopplerometry, ultrasound, amnioscopy and amniocentesis, and laboratory tests.

During cardiotocography, it is possible to track the fetal heart rate and its motor activity. By changing the heartbeat depending on the rest and activity of the fetus, its condition is judged. Cardiotocography, along with phonocardiography, is widely used in childbirth. Dopplerography of uteroplacental blood flow studies the speed and nature of blood flow in the vessels of the umbilical cord and placenta, the violation of which leads to fetal hypoxia. Ultrasound-guided cordocentesis is performed to collect cord blood and study acid-base balance. An echoscopic sign of fetal hypoxia can be a detectable delay in its growth. In addition, in the process of obstetric ultrasound, the composition, volume and color of amniotic fluid is assessed. Severe polyhydramnios or oligohydramnios can signal trouble.

Childbirth with chronic fetal hypoxia is carried out using cardiomonitoring, which allows timely application of additional measures. In acute hypoxia that developed during childbirth, the child needs resuscitation assistance. Timely correction of fetal hypoxia, rational management of pregnancy and childbirth can avoid the development of gross violations in the child. In the future, all children who developed under conditions of hypoxia are observed by a neurologist; often they need the help of a psychologist and a speech therapist.

Complications of fetal hypoxia

A severe degree of fetal hypoxia is accompanied by severe multiple organ dysfunctions in the newborn. With hypoxic damage to the central nervous system, perinatal encephalopathy, cerebral edema, areflexia, and convulsions may develop. On the part of the respiratory system, posthypoxic pneumopathy, pulmonary hypertension are noted; cardiovascular disorders include malformations of the heart and blood vessels, ischemic necrosis of the endocardium, etc.

The effect of fetal hypoxia on the kidneys can be manifested by renal failure, oliguria; on the gastrointestinal tract - regurgitation, vomiting, enterocolitis. Often, due to severe perinatal hypoxia, a newborn develops DIC, secondary immunodeficiency. Asphyxia of newborns in 75-80% of cases develops against the background of previous fetal hypoxia.

Prevention of fetal hypoxia

Prevention of the development of fetal hypoxia requires a woman responsible preparation for pregnancy: treatment of extragenital pathology and diseases of the reproductive system, rejection of unhealthy habits, rational nutrition. Pregnancy management should be carried out taking into account risk factors and timely monitoring of the condition of the fetus and woman. Preventing the development of acute fetal hypoxia lies in the correct choice of the method of delivery, the prevention of birth injuries.

Fetal hypoxia, what kind of phenomenon is known to many expectant mothers. Oxygen starvation is a diagnosis that “frightens” many pregnant women. Moreover, this diagnosis is often made unreasonably, and useless treatment is prescribed. Let's decide on how to determine fetal hypoxia, with the help of what studies and guided by what symptoms.

The expectant mother herself can suspect something is wrong from the second half of pregnancy, when she begins to feel the baby's movements. It is necessary to carefully monitor the frequency of movements. There should be at least 10 of them per day, at least 10 series are meant. For example, the child moved for a couple of minutes - this is one episode. Then an hour later, a couple more minutes - the second episode, etc. There is an opinion that the increased perturbation, as well as the so-called “hiccups” of the child, are the symptoms of fetal hypoxia, but doctors say that it is much more indicative, on the contrary, to reduce the number of perturbations and in general their absence.

If a pathology is suspected, a woman is recommended to perform CTG - this is an absolutely painless procedure in which, using a sensor, the fetal heartbeat is recorded. An experienced specialist who has made a transcript will be able to tell exactly how the child feels. It is customary to do CTG not only during pregnancy and if hypoxia is suspected, but also as a planned procedure during childbirth.

Another way to track the work of the heart and, in general, the blood supply in the placenta and umbilical cord is dopplerography. This procedure is performed on equipment for conventional ultrasound, and lasts approximately the same.

Also, a doctor who listens to it through the abdominal wall with an obstetric stethoscope can also suspect that something was wrong with the heart rate. A muffled heartbeat occurs only if the placenta is located along the anterior wall. By heartbeat, you can determine in what position the fetus is in the uterus, whether it is alone there (once in this way, women were diagnosed with multiple pregnancies). The heartbeat begins to be clearly heard through the abdominal wall from the second half of pregnancy. But even at the end of it, you are unlikely to be able to hear the baby’s heartbeat on your own with the help of a phonendoscope. A sharp decrease in heart rate - such signs of fetal hypoxia also have. Fortunately, the doctor listens to the baby's heart every time a woman visits, so a chronic process can be suspected at an early stage.

In addition, doctors pay attention to the findings of ultrasound. Indirectly, pathologies of the placenta can speak of hypoxia - its thickness is too large or, on the contrary, too small for the period, as well as its detachment and premature maturation. With such diagnoses, women are often placed in a hospital for prophylactic purposes.

Also, fetal hypoxia gives symptoms in the case of preeclampsia in the mother, diabetes mellitus, with a strong cough (especially with whooping cough), bronchial asthma, with a long stay in a stuffy room, lying on the back (the vena cava is squeezed), etc.

The consequences of fetal hypoxia vary depending on whether the condition is acute or chronic. Say, with premature maturation of the placenta or a woman smoking during pregnancy, the fetus regularly lacks oxygen, but this lack is not so obvious as to deal a fatal blow. Children who suffer from hypoxia in utero for a long time are often born weak, with small stature, weight, even if they are full-term. Acute hypoxia is much more severe. For example, with complete premature detachment of the placenta, the fetus can die from a lack of oxygen in a few minutes. With placental abruption, the relationship between the mother and child organisms is disrupted. In acute hypoxia, an urgent caesarean section is necessary. This is the only way to save the child.

And if it is sometimes impossible to prevent acute fetal hypoxia, then chronic can be successfully dealt with. First, you need to get rid of bad habits and, if possible, be in the fresh air as much as possible. Secondly, regularly visit a doctor and do all the necessary tests and examinations at the right time. Thirdly, make sure that there are enough iron-rich foods in the diet (to avoid iron deficiency anemia, a common cause of chronic fetal hypoxia). And fourthly, do not forget to tell your doctor about your respiratory diseases and other chronic diseases of various body systems, if any.

During pregnancy, any mother worries about the health of her unborn baby and wants him to swarm on time and strong. It often happens that at a scheduled appointment with a doctor, mommy hears such a word as “hypoxia”. What is "fetal hypoxia", how can it be avoided and how can it be cured?

Intrauterine fetal hypoxia- this is a lack of oxygen for the normal development of the fetus. Simply put, the baby inside the mother has nothing to breathe, more precisely, its still unformed organs have nowhere to get oxygen for formation, and if the organs are already formed, then there is no possibility for their normal functioning.

Hypoxia can occur both in the early stages of pregnancy and in its last weeks. It can also become an obstacle to the successful course of childbirth during labor. If you ask yourself why fetal hypoxia is dangerous, then it depends on the degree of hypoxia, its type: chronic or acute, the timing of diagnosis and compliance with the treatment prescribed by the doctor.

Chronic fetal hypoxia

Sometimes, in the absence of monitoring a pregnant woman (if she is not registered), with untimely diagnosis and treatment of this pathology, prolonged oxygen starvation occurs - chronic fetal hypoxia. The consequences of chronic fetal hypoxia are: violations of the formation of organs of the fetus, development of the embryo.

At a later date, this pathology causes damage to the central nervous system, a violation of physical development, which is characterized by growth retardation, poor adaptation of the child to existence outside the womb. In children born after chronic hypoxia inside the womb, poor appetite, anxiety and disorders of the autonomic nervous system are observed.

Acute fetal hypoxia

This type of hypoxia can occur at any stage of pregnancy and during labor. In this case, the diagnosis will sound like “acute fetal hypoxia”. This diagnosis is not conducive to any therapeutic intervention. With such a diagnosis, the woman is immediately placed in an emergency operation to extract the fetus in order to save his life. Every minute counts here. Prolonged lack of oxygen leads to the death of brain cells, therefore, to fetal asphyxia. The severity of the consequences of acute hypoxia is assessed on the Apgar scale immediately in the delivery room.

In general, fetal hypoxia can lead to consequences that will not really affect his life and development, he will be able to outgrow them by 5-6 years of life. Or, after fetal hypoxia during pregnancy, the born baby will fight for life for a long time, since his organs have not received proper development in the womb and will need treatment throughout his life.

Causes of fetal hypoxia

There can be many reasons for hypoxia. Intrauterine chronic hypoxia can be caused by the following reasons:

• mother's diseases (respiratory tract diseases, cardiovascular system, blood diseases);
• diseases of the fetus itself (Rhesus conflict, infections, congenital malformations, intracranial trauma);
• impaired blood flow due to prolapse of the umbilical cord, pressing the umbilical cord in breech presentation, entanglement of the umbilical cord around the limbs;
• severe and prolonged toxicosis is unpleasant and difficult for the mother, and this can affect the baby with hypoxia;
• with polyhydramnios or multiple pregnancies, babies may not have enough oxygen for normal existence and development, then additional measures should be taken to help them;
• overwearing can also cause oxygen starvation of the fetus;
• in addition, all pregnant women are told daily not to get upset, think only about the good and avoid stressful situations. Firstly, the baby himself tenses up when the mother is upset, and, secondly, during stress, the mother breathes less often, which disrupts the flow of the right amount of oxygen to the fetus;
• acute hypoxia occurs with tight multiple entanglement of the umbilical neck of the fetus;
• premature detachment of the placenta, rapid delivery or, on the contrary, protracted, knots on the umbilical cord, which prevent the flow of blood to the fetus, uterine rupture and much more;
• the use of an anesthetic during the birth process can also cause acute hypoxia; →
• prolonged stay of the fetal head in the pelvic area leads to oxygen starvation.

Hypoxia of the fetus and newborn

The above reasons are associated not only with fetal hypoxia, but also with asphyxia of the newborn. A newborn baby is considered in the first week after birth. During this period, all organs actively begin to work, which are reconfigured to work independently, without the help of the mother's body. So, if a child had intrauterine hypoxia, then it is likely that the same problem may arise in the first days of life.

The fact is that, with a lack of oxygen in the womb, the child tried to compensate for it by breathing through the open glottis. Amniotic fluid, mucus, blood could get there, which after birth will lead to blockage of the respiratory organs, and suffocation will occur - asphyxia of the newborn. That is why every second supervision is necessary for such children in the first days of life.

Hypoxia and fetal hypotrophy

We figured out what hypoxia is, and malnutrition is a lack of nutrition and underdevelopment of the fetus. This may be due to the same lack of oxygen, which is so necessary in the development of each organ, with the lack of proper nutrition. In most cases, malnutrition is a consequence of untreated or unnoticed hypoxia.

Fetal hypoxia: signs

In the first stages of pregnancy, it is impossible to determine fetal hypoxia without a Doppler examination (intrauterine examination of the fetal heartbeat) and ultrasound, since the fetus is not yet fully formed and cannot “tell” you that something does not suit him in your lifestyle and your condition.

Here, the diagnosis of fetal hypoxia comes to the rescue thanks to frequent and unscheduled examinations. Indicators for them can be your chronic diseases (diabetes, bronchitis, persistent cough, and others), your general condition, if you work in a stuffy room, and no one will release you from work there if there are certain contraindications.

In the later stages of pregnancy, the mother should monitor. When asked by a doctor about fetal movements, you get an answer on how to determine fetal hypoxia on your own. " Method 10”- this is the name of the assistant to identify signs of intrauterine fetal hypoxia.

Mom, waking up in the morning, saying hello to the baby, begins to count his movements. At least 10 episodes must occur per day. That is, you felt a stir for 2 minutes - the first series, then another minute - the second series, and so on.

Some doctors believe that increased fetal movements and hiccups are also symptoms of fetal hypoxia. But in fact, this can be a second indicator of excitement: mom unsuccessfully lay down (on her back, for example, which is unacceptable during pregnancy) or walked very quickly and now she also lacks air. If these phenomena quickly pass in the baby, then there is no reason to worry. But a decrease in the number of movements is already the most important symptom of intrauterine fetal hypoxia.

The development of acute fetal hypoxia is evidenced by turbid amniotic fluid, which is determined by their analysis.

How to recognize fetal hypoxia

First method about the detection of oxygen starvation was indicated above. The remaining methods are associated with an examination of a pregnant woman by a gynecologist at a scheduled or unscheduled examination.

The doctor, listening to the fetal heartbeat, pays attention to its frequency. If it is below the norm, then there is a need to conduct an additional examination. Listening to the fetal heartbeat with a statoscope through the mother's abdominal cavity begins in the second half of pregnancy.

More accurately traced the heart rhythm with the help of CTG (cardiotocography). This is an ECG for the fetus.

Signs of fetal hypoxia according to CTG are:

• absence or decrease in the number of heart beats;
• the presence of increased heart rate with involuntary contractions of the uterus and with fetal movements. The absence of such an increase indicates fetal tension and exhausted adaptive reactions.

And the third way is research with doppler ultrasound- intrauterine ultrasound, which allows you to examine the blood flow in the uterine arteries.

Also, a routine ultrasound examination can tell the doctor about the development of hypoxia - these may be disturbances in the development of the placenta, its premature maturation, too thick or thin walls.

Ordering some blood tests: hormonal and biochemical tests make it possible to detect the presence of enzymes in a higher concentration, fat oxidation products and other trace elements that indicate the development of such a pathology as fetal hypoxia.

Treatment of intrauterine fetal hypoxia

Having heard the diagnosis of “fetal hypoxia”, mommy becomes scared and the first thing that worries her is what should she do with fetal hypoxia. The main thing is to remain calm and follow the recommendations of the doctor. The calmness of the mother is the guarantee of the health of the child, not only already born, but also in her tummy.

If fetal hypoxia is diagnosed in time, and there are no indications for immediate surgery, then fetal hypoxia is treated. First of all, in the treatment of fetal hypoxia during pregnancy, they try to get rid of the mother’s illness as much as possible, which led to the occurrence of oxygen starvation (if it is revealed that it is she who is the cause of this).

Depending on the severity, treatment can take place in a hospital or on an outpatient basis. Rest and bed rest, taking medications prescribed by a doctor that help improve the supply of oxygen to the fetus, drinking oxygen-rich water are the main directions for treating intrauterine fetal hypoxia.

Fetal hypoxia during childbirth

During labor, the obstetrician-gynecologist who takes delivery periodically listens to the baby's heartbeat. So here the symptoms of hypoxia are tachycardia, fetal bradycardia, as well as the appearance of dull tones and arrhythmias in the fetal heartbeat.

The degree of bradycardia and tachycardia in different periods of labor may be different. In the first period, hypoxia is evidenced by bradycardia up to 100 beats per minute, and in the second it is already 98 beats.

In response to a contraction, with the development of hypoxia in labor, with the help of a radiotocograph, one can observe a decrease in heart beats up to 50 per minute.

The consequence of hypoxia during labor the child may swallow amniotic fluid, which further leads to disruption of the respiratory organs of the newborn.

How to avoid fetal hypoxia

To avoid hypoxia and the consequences of intrauterine hypoxia, you should lead a healthy lifestyle for two. First of all, you should get rid of all bad habits, especially smoking, and walk more in the fresh air away from highways and highways.

No one cancels a visit to a doctor during pregnancy, he will always be able to diagnose this pathology on time.

The diet should be balanced. Products containing iron must be present in your menu.

During the first examination, when you first register, tell about all chronic diseases (in principle, this is in the questionnaire when the pregnant woman card is filled out), and at subsequent visits, talk about respiratory diseases, if they appear.

By agreement with the doctor, breathing exercises can be performed to prevent fetal hypoxia.

Remember to get enough rest and sleep. Tips on how to avoid fetal hypoxia during pregnancy will help you easily endure a happy period of pregnancy, endure and give birth to a strong baby or baby.

During pregnancy, a mother should think not only about the baby, but also about herself, because the well-being of her unborn child depends on the state of her health. Wrong lifestyle and habits become the causes of fetal hypoxia during pregnancy.

Remember, everything that happens to you, one way or another is reflected in the baby. Take care of yourself and keep a close eye on the little miracle churning in your tummy.

I like!

I think there is no need to explain how important oxygen is in human life. Its lack can lead to death, and for a baby in the womb, it can cause malformations. However, if an adult feels this lack and can take measures to prevent hypoxia, then the unborn little man is not capable of this. And the expectant mother herself may not even suspect that the child in her stomach does not have enough oxygen. What to do in this case? How to notice the problem in time, and what to do to avoid fetal hypoxia during pregnancy?

What every mother needs to know about hypoxia

In fact, hypoxia during pregnancy is a violation of the uteroplacental blood flow, due to which the child receives less oxygen, which is important for its normal development and life. Hypoxia occurs in 10% of pregnant women and occurs most often in the early stages, which can lead to serious fetal malformations. In the later stages, it can provoke a lag in the physical and mental development of the fetus. Acute hypoxia during childbirth due to impaired blood supply to the baby's brain can cause damage to his central nervous system. As you can see, the problem is quite serious.

Diagnosis of impaired blood flow allows dopplerometry - a type of ultrasound, which, without indications, is routinely performed at 30-34 weeks of gestation. If there are violations, appropriate treatment is prescribed.

At earlier dates, dopplerometry can be performed according to the following indications:

• Rh-conflict of the child and mother;

• intrauterine infection;

• diabetes mellitus, kidney disease, hypertension in a pregnant woman;

• chromosomal pathology (detected during the first screening);

• multiple pregnancy;

• a lot or a lack of water;

• previous pregnancies with deviations (preeclampsia, miscarriages);

• entanglement of the umbilical cord (can be seen on any ultrasound during pregnancy);

• according to deviations during CTG (measuring the heart rate and assessing the motor activity of the fetus, it is planned at the 32nd week of pregnancy);

• anemia in a pregnant woman (low hemoglobin; accompanied by weakness, drowsiness, dizziness; diagnosed by a general blood test);

• thyroid disease in a pregnant woman;

• the age of the pregnant woman is younger than 20 or older than 35 years.

These same factors can cause the development of fetal hypoxia during pregnancy. In other words, the presence of one of these factors is already a cause for concern and should prompt you and your doctor to conduct additional examinations.

How to recognize fetal hypoxia during pregnancy on your own?

Despite the fact that medical diagnostics provide more accurate data on the condition of the fetus, many mothers are wondering how to recognize fetal hypoxia on their own. This concern is largely facilitated by the poor awareness of expectant mothers who are observed in state clinics.

So, the signs of fetal hypoxia during pregnancy are:

• a sharp increase in the activity of the baby in the womb. The movements of the fetus become sharper and more frequent than before. With the progression of hypoxia, movements, on the contrary, slow down until they completely disappear. This already clearly indicates the oxygen starvation of the fetus;

• increased or slower fetal heart rate. If you have a home fetal doppler, you can listen to the baby's heartbeat yourself.

Starting at 28 weeks pregnant, do the D. Pearson Count to 10 Fetal Movement Test. Your baby should move at least 10 times every 12 hours. If less, this is a sign of fetal hypoxia.

Please note that only a doctor can make an accurate diagnosis. Extra panic without a medical examination, because "something seemed" to you now is only to your detriment.

How to treat fetal hypoxia during pregnancy?

There are a number of drug methods for restoring uteroplacental blood flow. The doctor will prescribe the treatment for you. At home, try to provide yourself with bed rest. You should not lie on your back, because. this can lead to compression of the inferior vena cava, which supplies oxygen. Lie more on your left side.

It is also helpful to periodically ventilate the room in which you are, and walk at least 30 minutes a day in the fresh air.

How to prevent fetal hypoxia during pregnancy?

To prevent hypoxia, follow these recommendations:

1. Walk outdoors every day.

2. Do not spend more than 1 hour in a sitting position. Try to move more often, and even better, sign up for yoga for pregnant women or take video courses that you can find on the net. Please check with your doctor beforehand. After all, some exercises may be contraindicated for you.

3. In the absence of tone and the threat of miscarriage, it is useful to do aqua gymnastics or ordinary swimming.

4. Drink oxygen cocktails and water enriched with oxygen. Despite the fact that their effectiveness has not been clinically proven, moms' reviews of these drinks are mostly positive. In any case, when used in moderation, they will not bring harm.

Breathing exercises for hypoxia for treatment and prevention

1. Stand up straight, spread your legs shoulder-width apart. While inhaling, slowly raise your arms up through your sides and stretch on your toes. As you exhale, return to the starting position. Repeat the exercise 8 times.

2. Sit on your heels with your legs bent under you. Place one hand on your chest, the other on your stomach. Inhale deeply through your nose, then exhale through your mouth. Feel the movements of your chest and abdomen. 5-6 times will be enough.

3. Get on all fours. Straighten your arms completely. On an inhale, arch your back and lift your head up. As you exhale, round your back and lower your head down. Repeat 4-6 times.

Exercises for hypoxia and for its prevention should be performed slowly and in a calm environment. Make sure no one bothers you. At the end of the complex, lie on your back and just breathe in the usual rhythm.

As you can see, the problem of hypoxia is solvable. It is enough to follow simple recommendations and be observed regularly. good luck to you