Intrauterine fetal hypoxia
Intrauterine hypoxia of the fetus is called oxygen starvation of the fetus in the womb.This condition is not an independent disease, it is rather a consequence of various pathological processes in the body of the mother, the fetus or in the placenta.
How does intrauterine fetal hypoxia
If oxygen starvation of the fetus has only just begun, the future mom can mark restless behavior and increased motor activity fetus.Moreover, these manifestations will be intense, but there will be no connection between physical loads and active movements of the fetus.
Unfortunately, many expectant mothers rarely seek qualified medical care at too high fetal activity, but oxygen deficiency continues to progress - the second phase begins.It will be characterized by a decrease in the motor activity of the fetus, a decrease in the frequency and strength of the tremors.If a woman notes that the fetal movement has decreased to 3 times per hour, then this is the reason for going to the doctor.
In a study of pregnant women with suspected intrauterine fetal hypoxia doctors noted palpitations last up to 160 beats per minute, muffled heart sounds, and a decrease in heart rate to 100-120 beats per minute.
Classification intrauterine fetal hypoxia
Considered condition may occur in three different forms, the differentiation depends on the speed of progression of the pathological process:
- lightning;
- acute - usually develops during labor and has a duration of several minutes or hours;
- subacute - develops shortly before birth( 1-2 days);
- is chronic - typical for toxicosis, infection of the fetus, pregnancy, maternal and fetal incompatibility.
Causes of intrauterine fetal hypoxia
in principle, to consider the state can cause any pathological processes occurring not only in the body of the child, but also a woman. Doctors distinguish only a few of the reasons that are most often detected during the examination of a pregnant woman :
- Placental insufficiency.Insufficient supply of oxygen and nutrients to the fetus occurs due to circulatory disorders in the mother / placenta / fetus system.
- Rupture of the uterus.
- Anemia, diabetes mellitus, cardiovascular diseases of the mother.
- Premature detachment of a normally located placenta.
- Severe late toxicosis( gestosis).
- Weakness of labor or its discoordination( anomalies of labor).
- Cord obtuse.
- Intrauterine infection of the fetus.
- Prolonged squeezing of the head during labor.
- Malformations of the fetus of an innate character.
- Partial or complete overlapping of the placenta of the uterine throat - placenta previa.
- Intoxication of the mother's body.
- Pregnancy pregnancy.
Examinations
To determine the fact of the presence of oxygen starvation of the fetus and to understand the extent to which this pathology occurs, doctors perform a range of diagnostic events. Within the framework of these surveys women spend:
Cardiotocography
enables to detect contractions of the heart of the future baby, further specialist will assess motor activity fetus. For the healthy fetus, the following heartbeat characteristics will be characteristic:
- heart rate ranges from 120-160 beats per minute;
- the frequency of contractions increases, as a response to fetal movement or a sharp change in the position of the body of a pregnant woman;
- complete absence of heartbeat deceleration.
In the case of oxygen starvation of the fetus, the specialist will identify :
- a significant disturbance in the rhythm of the heartbeat - it will be either increased or delayed;
- total absence of increased heart rate in response to perturbations or contractions - a monotonous rhythm;
- rhythm cuts, which will be frequent and deep.
Ultrasound with dopplerography
In ultrasound examination, a physician can determine the state of the blood circulation in the mother / placenta / fetus system at a time beyond 20 weeks of gestation.If uterine arteries are to be examined, violations of uteroplacental blood flow at the earliest stage of development can be detected, which will prevent the progression of severe fetal hypoxia.
As additional results, the physicians determine the structure of the placenta and the level of amniotic fluid( amniotic).
Calculation of fetal movements
It should be noted immediately that this particular method of diagnosis is inaccurate, therefore it is used only for pregnant women of low risk, that is, the future mother does not have chronic diseases or lacks the developmental defects of the unborn child.Such a survey can reveal hypoxia at the first stages of progression, which is determined by the change in the motor activity of the fetus.
You can perform such a test without going to the doctor's office.The woman should lie on her side in a position convenient for her and concentrate on the movements of the child.If within 60 minutes the expectant mother will feel less than 10 movements, then you should always seek qualified medical help.
Important: , this test can be performed after 25 weeks of gestation.
An alternative is the test of D. Pearson "Count to ten."It is applied starting from the 28th week of pregnancy.Movements are counted from 9 am to 9 pm.The time of the 10th movement should be recorded.If you do not move a little, you should inform your doctor about it.
Possible consequences of intrauterine fetal hypoxia
Why do doctors insist that a woman, even in case of doubtful assumptions about the disorders of pregnancy, seek medical help?The fact is that even mild intrauterine hypoxia of the fetus can lead to the development of very unpleasant consequences.
If acute fetal hypoxia is diagnosed, the consequence of this condition may be:
- intestinal necrosis;
- high risk of sudden infant death;
- inhalation of meconium and pneumonia;
- premature delivery;
- risk of developing infantile cerebral palsy in a child;
- high risk of intrauterine fetal death;
- affection of the fetal nervous system, up to coma.
In the case of the presence of chronic intrauterine fetal hypoxia, the consequences can be as follows:
- at birth, the baby will have a small growth and a critically low weight;
- anemia of the newborn;
- high susceptibility to infectious diseases;
- attention deficit disorder and hyperactivity in older children;
- insufficient temperature regulation of the body in the newborn.
Most of the consequences are due to brain hypoxia and premature birth, because in order to save the baby's life, doctors perform emergency delivery much earlier than the due date.
Note: on statistics, if a child with diagnosed intrauterine hypoxia has safely survived the first month after birth, then the pathological condition in question has no consequences.
Treatment of intrauterine fetal hypoxia
The choice of tactics for treating the pathological condition in question depends on the state of the mother's health, the duration of pregnancy, the presence of concomitant diseases in the future mother.Since the reasons for the development of intrauterine hypoxia are variable, there is no single principle of its treatment - everything is done in a strictly individual order. If the state of health of both the woman and the fetus allows, then the doctor can apply conservative methods of treatment of intrauterine fetal hypoxia:
-
Improving the health of a future mother - for example, treating chronic diseases, eliminating anemia, stabilizing blood pressure.In addition, improve the health of the mother can be by selecting an individual diet and life, getting rid of bad habits, the introduction of a light physical load. - Assignment of anticoagulants.These drugs help normalize the level of blood viscosity.Apply this treatment only if a woman has a clotting disorder.
- Amnioinfusion.This method is used extremely rarely, it is justified, for example, with a pronounced delay in fetal growth and diagnosed infertility.Under amnioinfusion means the introduction of a special drug into the amniotic fluid, which makes it possible for a child to develop lightly, reduces the level of oxygen starvation, prevents meconium from entering the baby's body.
- An infusion of magnesia.This method is used only in the case of diagnosed hypertension in a pregnant woman.Such intravenous injections prevent the development of eclampsia and significantly reduce the risk of oxygen starvation.
- Purpose of anti-inflammatory and antimicrobial agents.It is advisable to carry out such treatment only if infectious processes have been diagnosed.
Note: in medicine there is no single drug that is able to cure placental insufficiency.All of the above methods contribute to getting rid of fetal factors triggering the intrauterine hypoxia.If the placental blood flow is diagnosed, then the doctors only observe the future child in order to carry out an emergency delivery in time.The more the fetus lags behind in development from the norm, the earlier it is necessary to carry out an emergency delivery.
Intrauterine hypoxia of the fetus is a pathological condition that can lead to serious consequences.It is almost impossible to make any predictions about the probability of developing the condition in question, therefore, women who are at the planning stage of pregnancy should not only undergo a full examination with specialized specialists, but also abandon bad habits.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category
