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How is oxygen deprivation in the fetus determined? Effective measures for the prevention of fetal hypoxia for expectant mothers. The danger of hypoxia for the fetus and its consequences

In this article:

What is fetal hypoxia?

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

Pathology can occur on early dates pregnancy, and later. Regardless of the time of manifestation similar state the consequences of oxygen deficiency are always unfavorable for the unborn child. Intrauterine fetal hypoxia that occurs in the early stages can lead to developmental abnormalities.

Manifestation of hypoxia for more later dates 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 minor, short-term hypoxia, most likely, will not negatively affect the health of the unborn baby. But long-term or heavy oxygen starvation can lead to irreversible consequences.

In order to prevent the development of pathology, one should be aware of the causes of hypoxia, signs of impairment, methods of preventing such a condition.

Reasons for the manifestation 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, it is various diseases expectant mother (for example, disruption of work of cardio-vascular system, intoxication, anemia, etc.), as well as disruptions in normal functioning placental blood flow, for example, due to gestosis, prolongation, pathologies of the umbilical cord and placenta. Diseases of the fetus, for example, such as anemia, malformations, can also cause hypoxia.

A lot is known about the mechanisms of the development of pathology: a violation of the supply of the uterus with oxygen and metabolic processes of the placenta, a deficiency of hemoglobin, and manifestations of cardiovascular insufficiency lead to hypoxia.

Some doctors, discussing 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 in nature.

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

Among these diseases are:

  • intoxication of the body due to poisoning, toxicosis, harmful conditions labor or functional disorders in the work of 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 number amniotic fluid);
  • toxicosis in the last months of pregnancy -;
  • malfunction of the placenta or uteroplacental blood flow.

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

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

Signs

It's important not to miss the first signs. intrauterine hypoxia fetus. After all, in most cases, on time Taken measures avoid negative consequences, which will invariably appear during prolonged oxygen starvation.

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

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

Another sign, which in some cases, can indirectly tell a pregnant woman about the presence of problems in the unborn child is a change in the usual motor activity of the fetus. With light oxygen starvation, his behavior becomes restless, 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 the doctor, you should independently observe the movements of the unborn child for several hours.

At the disposal modern medicine There are many research methods that, with varying accuracy, make it possible to confirm or deny the presence of oxygen deficiency, to determine the degree of danger to the fetus. Among the methods used, one can single out the most accurate and informative CTG (cardiotachography), phonocardiography, dopplerometry, study of amniotic fluid (amnioscopy).

The possibilities of ultrasound scanning are also widely used, thanks to which it is possible to identify the irregular breathing movements performed 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 about the ill-being of a child who is being born. One of the signs of acute oxygen starvation is green waters colored with meconium.

Consequences for the child

The consequences of fetal hypoxia 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 that an improvement in a dysfunctional state will come by itself! The longer and more intense the oxygen starvation, the stronger the changes taking place 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 electrolyte balance is disturbed in the body of an unborn child, 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 lead to fetal death or serious asphyxiation of the newborn.

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

Prophylaxis

Prevention of fetal hypoxia consists in regular medical supervision of a woman throughout pregnancy. Timely diagnostics and treatment started on time have great importance for the health of the child. Identifying complications of pregnancy, monitoring the condition of the fetus are the doctor's tasks. The expectant mother should lead a correct lifestyle, give up harmful or dangerous work, try to avoid anxiety.

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

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

Methods for the treatment of fetal hypoxia

In treatment chronic hypoxia the knowledge and experience of the doctor are important, as well as correct attitude and the discipline of the expectant mother. Prescribed medication alone is usually not enough. Often a woman has to reconsider during pregnancy own image life, having made a choice in favor of quiet rest... Sometimes for the baby's health, you need to take bed rest which helps to improve the blood supply to the uterus.

Often, if hypoxia is suspected, the doctor decides on hospitalization of 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, they carry out therapy 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).

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

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

If complex therapy does not bring the desired effect and the condition of the fetus worsens, while the gestational age exceeds 28 weeks, they resolve the issue of emergency childbirth by conducting caesarean section.

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

conclusions

Hypoxia can be dangerous for 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 unwanted consequences when pathology occurs.

Whenever possible, a pregnant woman should avoid stressful situations... Strong excitement is not the best way affect the health of the expectant mother, affect the development of the fetus.

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

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When, after an examination by a doctor, a pregnant woman learns that she has a diagnosis of intrauterine fetal hypoxia, she becomes restless. Expectant mothers have questions about this diagnosis, the consequences and methods of preventing it.

What is fetal hypoxia

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

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

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

The child's condition does not change in any way from 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 appearance of the likelihood of death.

Lack of oxygen at different times of pregnancy can have a wide variety of consequences for the baby. When it occurs in the first stages of pregnancy, the child develops in the mother's womb more slowly, developmental irregularities appear. There is high risk the fact 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, significantly reduce his adaptive capabilities.

Causes of fetal hypoxia

There are many factors that affect 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 anemia. The presence of this disease implies a disruption in the work of red blood cells, provoking an incorrect supply of oxygen to important cells of the body.

If there are heart defects, diseases of the muscular middle layer of the heart, diseases of the lungs, diseases of the myocardium, as well as with increased loads on these organs, in pregnant women most often there is insufficient blood flow. At poor circulation a violation of microcirculation in tissue cells is recorded, which leads to gradual development fetal hypoxia and impaired 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. respiratory system... Such diseases appear as a result respiratory failure, which leads to hypoxia of organs and tissues of the pregnant woman and affects the fetus. Fetal hypoxia can develop due to kidney disease, diabetes mellitus.

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 result from the development of fetal diseases: hemolytic disease (a condition that occurs when the child's blood group is not compatible with the blood group 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 baby's heart rate. The fetal heart rate in normal mode is 120-160 beats / min. The palpitations can 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 occurs when the fetal heart rate is less than 70 beats / min. For the correct diagnosis of fetal hypoxia, the following are used: cardiography, studies of the state of amniotic fluid, dopplerometry, blood analysis of a pregnant woman (hormonal and biochemical methods), auscultation, fetal electrocardiography.

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

Symptom of necessity urgent appeal to the doctor are the movements of the child less than three times during an hour and their repetition, as well as a 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 caused by an untimely diagnosis of pathology. Chronic fetal hypoxia is possible in the absence of timely diagnosis of the complication. As a result of the development of chronic hypoxia, the formation of organs and the process of fetal development are disrupted even at the embryonic stage. At the same time, pathological changes The central nervous system of the fetus, significantly disturbed physical development, which leads to stunting, difficulty in adapting the infant to life outside maternal 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 in the process generic activity an acute form of this pathology may occur. At acute form 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 admitted to the 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 starvation can result in the death of brain cells, leading to fetal asphyxia, there is usually very little time in this situation. The level of severity of the consequences of this type of pathological changes is estimated by obstetricians by special system Apgar immediately after childbirth 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 to terminate the course of pregnancy;
  • respiratory diseases;
  • the presence of various infections of the genitourinary system;
  • endocrine diseases (for example: thyroid diseases and diabetes mellitus);
  • disorders of the functioning of the cardiovascular system (heart disease, abnormal pressure, vegetative dystonia);
  • incompatibilities between mom and dad of blood type and Rh factor;
  • too early either late age pregnant;
  • use by a pregnant woman alcoholic beverages etc.;
  • not correct image life of the future mother.

Diagnosis of fetal hypoxia

Diagnosis is carried out by assessing 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 urgent 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 detect sounds emanating from the heart and other organs. The task of the doctor is to assess the speed and nature of heart contractions, to determine the sonority of heart sounds.

However, according to modern medical specialists, the auscultatory method has questionable accuracy of its results. Since the counting of heart contractions in the fetus can be erroneous by 10-15 beats / min. Based on the heart rate indicators, you can find out how the fetus is located in the uterus, whether there are still fetuses there. The baby's heart can be easily heard through the mother's belly during the second trimester of pregnancy.

The method of cardiotocography (CTG) is used in the process of diagnosing fetal hypoxic conditions. It is possible to carry it out using an ultrasonic sensor, which is installed on the belly of the pregnant woman at special points for maximum audibility of the heartbeat. Recording of heartbeats with KGT is made on paper. Important elements diagnostics are the answers to the following questions: how many heart contractions, how frequent and reduced heart contractions (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 uterine tone... Indicator normal state a baby in the womb is the occurrence of acceleration as a reaction to the baby's movement 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 present at all or should be a minimum amount.

A non-stress test (NST), which measures only acceleration, can be performed within the described method. 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%. The tension and depletion of adaptation and adaptation responses of the fetus can be recorded with non-reactive NBT.

For the reliability of the data, they should be combined with the definition of FFP ( biophysical profile fetus). For this purpose, the development of five components was carried out:

  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. muscle tone of the child.

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 level of severity of fetal hypoxia depends on the violations, due to which it can be planned how the pregnancy will go on and how the delivery will take place. Good effect has such a diagnostic method as an ECG of the fetus, as well as a blood test for 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 that records the fetal heartbeat. For an accurate understanding of the state in which there is future child, a specialist makes a decryption. CTG is a diagnostic option used both during pregnancy and as a routine procedure during childbirth.

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

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 a lack of oxygen in the child. Also, in order to normalize the blood flow of the placenta, certain therapeutic procedures... Bed rest helps to improve the blood flow of the uterus, so the pregnant woman should definitely follow it.

It is possible to reduce the contractility of the uterus with the help of certain medicines prescribed by doctors:

  • (administered intravenously)
  • Bricanila

The complex therapy also consists of a method for reducing blood viscosity. Due to this, the tendency to form blood clots can be reduced, as well as blood circulation in small vessels can be restored. Obtaining the effect is guaranteed with the use of the following drugs:

  1. Rheopolyglucin (endocrine and hormonal drugs)
  2. Curantila (prevents platelet adhesion and blood clots)
  3. Aspirin in extremely low doses

Treatment chronic form diseases can be produced through the adoption of Lipostabil or Essentiale-Forte, which favorably affects the passage of oxygen to the cells. Specialists can also prescribe medications with the help of which the metabolism in cells will be improved:

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

The pregnant woman is prescribed delivery in urgent order, if complex treatment fetal hypoxia did not bring positive results.

It should be borne in mind that observing bed rest, the mother needs to take the "crocodile pose" - on the left side. Treatment is also done with oxygen therapy.

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

To improve blood circulation between the uterus and the placenta, such medications, like sygetin (2 milliliters - 1%), Euphyllin (10 milliliters - 2.4%), Curantil (2 milliliters - 0.5%), ATP (2 milliliters -1%). Introduction Reopoliklyukin is carried out in 200 milliliters intravenous drip. At premature pregnancy and increased uterine excitability, as well as in other cases, tocolytics bring a certain effect. Intravenous drip is injected 25% in 5% glucose solution 10 milliliters or alupent (0.5 milligrams) in 5% glucose solution. After completing a 2-6-day course, the drug is administered intramuscularly or treated with tablets.

Treatment of acute fetal hypoxia

It has already been noted that expectant mother you need to be in the "left" position. The use of continuous inhalations of pure humidified oxygen through a well-fortified mask is recommended. Glucose, insulin, ascorbic acid solution and cocarboxylase are injected intravenously.

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

With the sudden development of fetal bradycardia, a pregnant woman is injected with 0.3% milliliter IV or 0.7 milliliters s / c 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 treatment methods, the pregnant woman is prepared for premature birth.

Fetal hypoxia during childbirth: features and treatment

The obstetrician's obligations 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 timeframes generic activity. Bradycardia at the first stage of hypoxia development is 100 beats / min, at the second stage - already 98 beats / min.

The swallowing of amniotic fluid and blood by a baby is the main consequence of hypoxia during childbirth. This fact leads to disruption of the functioning of the child's respiratory system. Fetal hypoxia during childbirth is most often recorded in premature babies, with too prolonged childbirth, with the appearance of bleeding, upon contact various infections into the baby's body. Asphyxia is a suffocation that occurs 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, entrapment of the umbilical cord and other factors.

We all know that during pregnancy, a woman's thoughts are directed in one direction. She dreams of a future baby, a happy one life together, already cares about his condition and comfort and wants the baby to be born strong, healthy and on time.

In order for the fetus to develop fully during pregnancy and childbirth to be successful, all processes in both organisms - child and mother - must proceed normally, as expected. Any violation can affect the condition of the baby. And such a situation can arise for many reasons. Often, pregnant women are diagnosed with fetal hypoxia. And this serious reason think and act.

What's happening?

The word "hypoxia" means oxygen deficiency. That is, when it comes to fetal hypoxia, this means that the baby receives less oxygen from the mother's body, and oxygen starvation of the fetus occurs, as doctors say. This condition can develop during pregnancy (and then diagnosed with chronic hypoxia) or directly during childbirth (we are talking about acute hypoxia).

What happens when there is not enough oxygen? Of course, the baby starts to choke. But this is not immediate. Before, in his small body, there are a number of disorders, the consequences of which, if hypoxia is not detected and therapeutic measures are not taken in time, can be irreversible.

Lack of oxygen in the early stages of pregnancy (when the laying and formation of organs and systems occurs) can provoke a violation of the development of the embryo, up to anomalies and injuries. And in the later stages, the child's central nervous system and physical development suffer: growth retardation occurs, the newborn adapts worse to the new environment, may have physical and psychical deviations... Children born with hypoxia have disorders of the autonomic nervous system, muscle hypertonicity, the baby is restless, naughty, eats and sleeps poorly. Such a child should be under constant supervision of a neurologist.

When the fetus experiences a lack of oxygen, all of its organs and systems begin to work in an enhanced mode, trying to get a vital gas for itself. This is possible due to the increased compensatory capabilities of the small organism. The woman feels this activation by the increased mobility of the baby. But this may not last long. And if the normal oxygen supply is not restored and the metabolism is not normalized on time, depression soon sets in - the baby calms down, because without oxygen he can no longer move. The consequences of this condition may be irreversible. Therefore, if, after a sudden increased activity, your baby suddenly freezes (you feel no more than 3 movements per hour), you should consult a doctor immediately! It is possible to identify hypoxia with the greatest certainty by additional research: cardiotocography and dopplerometry.

Why does this happen?

Oxygen enters all our organs and systems along with the blood. It transports oxygen, and without iron, it is not produced. That is, with (iron deficiency), the production of hemoglobin and, accordingly, the flow of oxygen into the blood and further throughout the body naturally decreases. However, the lack of iron in the mother's blood is not the only reason the occurrence of hypoxia.

During pregnancy, the volume of circulating blood in the mother's body increases significantly, because she feeds the fetus through the placenta. If the uteroplacental exchange worsens, the embryo cannot receive required amount of all nutrients, including oxygen supplied to it with the maternal blood. Metabolic disorder between mother and fetus occurs when placental insufficiency... Blocks the flow of oxygen to the fetus during pregnancy, as nicotine constricts blood vessels and blood circulation is impaired. It is also known that tobacco smoke penetrates to the embryo through the placenta, and it ends up in a smoke screen - how can one not suffocate ... It does not work well on blood vessels and.

In general, the development of hypoxia can provoke a number of diseases (especially chronic diseases women) and disorders in the organisms of the fetus and mother and in the placenta:

  • cardiovascular diseases of a pregnant woman;
  • anemia;
  • lung disease (respiratory tract);
  • deep;
  • preeclampsia;
  • overburdening;
  • polyhydramnios;
  • multiple pregnancy;
  • violations at;
  • a threat ;
  • pathology of the placenta and umbilical cord;
  • abnormalities of labor;
  • intrauterine infections, intoxication;
  • hemolytic disease of the fetus;
  • prolonged squeezing of the head during childbirth and others.

Thus, hypoxia should be considered as a condition caused by a complex of changes in the body of the mother and child.

How to treat?

If a pregnant woman is diagnosed with hypoxia, she may be admitted to a hospital to ensure complete rest and provide the necessary treatment. Although it is quite possible that it will be possible to be treated at home with a visit to a clinic or hospital. The doctor must find out what disease caused the development of hypoxia and prescribe the appropriate treatment.

The therapy is carried out in a comprehensive manner. However, if positive dynamics are not observed and the condition of the fetus worsens, the issue of performing a caesarean section is considered (but this is only for a period of at least).

How to prevent?

Fetal hypoxia is diagnosed in approximately 10.5 percent of women. However, in order not to get on their list, you just need to adhere to a certain lifestyle during pregnancy.

The most important thing is not to smoke or drink alcohol. If possible, breathe only clean air... That is, if you live in a very gas-polluted area, move to a cleaner area during this time. Ventilate the room in which you live as often as possible. Settle at fresh air, but do not forget about good rest.

Adequate and prevention of iron deficiency anemia are of paramount importance.

Of course even healthy image life and good nutrition cannot become an absolute guarantee that hypoxia will not develop during pregnancy. But this will significantly increase your chances of preventing it. In addition, regular check-ups with a gynecologist and consultations with a doctor will help to identify something amiss in time.

Acute fetal hypoxia

A few more words about the lack of oxygen experienced by the child directly during childbirth - acute fetal hypoxia. This condition can occur for a number of reasons: very rapid or very prolonged labor, when a baby stuck in the birth canal simply has nothing to breathe; entanglement of the fetus with the umbilical cord; premature detachment placenta. All this leads to fetal asphyxiation (suffocation).

If acute hypoxia develops, the delivering doctor monitors the condition of the fetus, in particular, conducts cardiac monitoring, monitoring cardiac activity. A prerequisite for this may be cloudy greenish waters: it means that meconium got into them. Such a criterion can be taken into account only with a cephalic presentation of the fetus. In addition, acute hypoxia can be judged by the analysis of amniotic fluid and fetal blood tests (by the pH level).

A protracted increasing state of hypoxia during childbirth is an indication for an emergency caesarean section.

But it should be understood that even acute hypoxia has its roots in the gestation period. And if the violations and changes occurring at this time are identified in advance, then many troubles can be avoided.

Specially for- Elena Kichak

Fetal hypoxia (oxygen starvation) is a pathological condition during pregnancy resulting from the supply of oxygen to the tissues of the body in insufficient quantity, or in violation of oxygen absorption by tissues. Hypoxia occurs both during gestation and during childbirth.

10% of pregnancies and childbirth are accompanied by intrauterine fetal hypoxia. Medicine has studied this pathology, is able to identify and eliminate hypoxia, but, unfortunately, the number of cases of the development of pathology does not decrease. Obstetricians rank this pathological condition as a serious cause of morbidity and mortality. born babies and newborn babies in the first week of life.

Fetal hypoxia during pregnancy develops slowly when there is a lack of oxygen in the body, or rapidly if the placenta is depleted. Pathology is conventionally divided into two types - acute and chronic fetal hypoxia.

Fetal hypoxia is not a separate disease, but a condition caused by a complex of changes in the body of a woman or an unborn child, which lead to oxygen deficiency and the development of adverse consequences.

Signs and symptoms of fetal hypoxia

The appearance of signs of fetal hypoxia occurs in the second half of a woman's pregnancy, when the baby begins to move in the womb.

If the pathology develops on early stage, then no symptoms may appear. At this time, mom will feel fine. In late pregnancy, pay attention to fetal mobility. Hypoxia can be recognized by recording the frequency of the child's movements. Ten times a day, the child begins to move in the womb for several minutes, and then calms down for 1-2 hours. Decreased mobility is a symptom of a poor oxygen supply to the body. With an exacerbation of oxygen deficiency, the baby in the womb may not move, since the body cells are depleted.

In the second half of the pregnancy, the baby's heartbeat is heard through abdominal cavity with an obstetric stethoscope. If routine examinations are carried out regularly, then the doctor is able to determine the symptoms of fetal hypoxia at an early stage and prescribe necessary treatment... Signs of initial fetal hypoxia include:

  • tachycardia (over 160 beats per minute) or bradycardia (below 120 beats per minute);
  • decreased heart rate variability;
  • monotony of rhythm;
  • weakening of the reaction to functional tests;
  • late decelerations.

Another indirect symptom of fetal hypoxia: if the placenta begins to exfoliate too early in a pregnant woman. Premature maturation also applies to such symptoms.

Pathological symptoms in a woman appear at 35-36 weeks of pregnancy. These include:

  • depression;
  • frequent insomnia;
  • fatigue;
  • fatigue;
  • frequent nausea.

After 36 weeks, impaired pressure often appears, as well as problems with the organs of hearing and vision.

If hypoxia persists after 35-36 weeks of pregnancy, the pathology becomes chronic.

Acute and chronic fetal hypoxia

If hypoxia develops gradually, then we are talking about chronic insufficiency oxygen. Chronic fetal hypoxia appears only when carrying a child.

Sometimes, the lack of oxygen occurs suddenly. This condition is typical for childbirth and is called acute fetal hypoxia. Acute hypoxia occurs due to:

  • protracted labor;
  • weak labor activity;
  • rupture of the uterus;
  • premature placental abruption;
  • entwining the child with the umbilical cord or the formation of knots on the umbilical cord;
  • incorrect presentation.

Acute fetal hypoxia is extremely dangerous: brain cells quickly die in the absence of oxygen supply.

Causes of fetal hypoxia

The reasons for the development of fetal hypoxia are divided into three groups.

Pathological conditions that are not associated with pregnancy and childbirth

  1. cardiovascular diseases:
    • heart defects;
    • hypertonic disease.
  2. respiratory diseases:
    • Chronical bronchitis;
    • emphysema of the lungs;
    • bronchial asthma.
  3. kidney disease:
    • chronic renal failure;
    • amyloidosis.
  4. metabolic disease:
    • diabetes.
  5. diseases in which occur:
    • extensive blood loss;
    • severe intoxication;

Disruption of fetal-placental blood flow

This group includes pathological conditions directly related to pregnancy, which, to one degree or another, are capable of causing impaired blood flow:

  • early and late gestosis;
  • the threat of premature birth;
  • premature detachment of a normally located placenta;
  • prolongation of pregnancy;
  • abnormal attachment of the placenta;
  • multiple pregnancy.

Fetal diseases

  • hemolytic disease, which develops as a result of the Rh-conflict between the mother and the fetus;
  • congenital malformations;
  • intrauterine infections;
  • pathology of the development of the umbilical cord;
  • protracted labor.

Consequences of fetal hypoxia

Depending on the degree of oxygen deprivation before and during childbirth, the consequences for the baby vary.

The prognosis of complications is determined according to the assessment of the condition of the newborn child according to the Apgar scale. If immediately after birth the child's condition was assessed at 4-6 points, and at the 5th minute - 8-10, then the consequences are of moderate severity. If the Apgar scores are lower - severe consequences... This means:

  • neurological disorders;
  • hyperactivity;
  • lag in mental or physical development;
  • mental and speech pathologies.

In the case of diagnosing hypoxia in a child after birth, the help of a neuropathologist will be needed, and in the future - a child psychologist and speech therapist.

Treatment of fetal hypoxia

Early detection of hypoxia, combined with the lack of recommendations for an urgent caesarean section, makes it possible to treat the disease during pregnancy in order to reduce the likelihood of the baby getting sick after birth.

Drug treatment of hypoxia involves the appointment of the following drugs:

  1. drugs that reduce the contractility of the uterus:
    • no-shpa;
    • bricanil;
    • ginipral;
    • candles with papaveril.
  2. drugs that restore blood circulation:
    • chime;
    • aspirin.
  3. drugs that improve the permeability of cells to oxygen:
    • lipostabil;
    • Essentiale Forte.
  4. drugs that restore metabolism:
    • glucose;
    • vitamin E;
    • ascorbic, glutamic acid.

Treatment aimed at increasing fetal oxygenation, improving uteroplacental blood circulation and normalizing fetal metabolic processes is carried out in a hospital or on an outpatient basis.

Treatment for fetal hypoxia includes:

  • UV irradiation;
  • inductothermia or diathermy of the perirenal region;
  • intravenous infusion of glucose with cocarboxylase and ascorbic acid;
  • oxygen therapy;
  • oral administration (intravenously in a hospital setting) trental, b-adrenergic agonists.

In case of signs of acute fetal hypoxia, urgent hospitalization of the pregnant woman and emergency treatment of fetal hypoxia during transportation are required. In acute fetal hypoxia, inhalation of a humidified 60% oxygen-air mixture for 20-30 minutes with simultaneous intravenous administration of 50 ml of a 40% glucose solution with 300 mg of ascorbic acid, as well as 1 ml of a 10% cordiamine solution to a woman is beneficial. Cordiamine is administered subcutaneously or intramuscularly (2 ml each).

Inhalation of an oxygen-air mixture is used after preliminary intravenous administration of antispasmodics or b-adrenergic agonists to a woman. In addition, intravenous administration of 2-4 ml of 1% sygetin solution and 20-40 ml of 20% glucose solution, cocarboxylase (100 mg intramuscularly or intravenously) helps.

If acute fetal hypoxia occurs during childbirth, the cause of this pathological condition is eliminated. Simultaneously perform the above treatment; in addition, first 100 ml of 5% sodium bicarbonate solution is administered intravenously to a woman in labor, and then 100 ml of 10% glucose solution.

In the absence of the effect of the therapy, do operative delivery(forceps, vacuum extraction, caesarean section).

Fetal hypoxia

Diagnosis of fetal hypoxia

Each expectant mother, starting from the 20th week, keeps a self-control diary, in which she notes locomotor activity fetus. Warning signs:

  • restless fetal behavior;
  • increase or decrease (in the daytime less than three times per hour) perturbations.

If you suspect fetal hypoxia, you should urgently consult a doctor for additional examination... It includes the following methods:

Forecast and prevention of fetal hypoxia

In the treatment of chronic fetal hypoxia, rational management of pregnancy and childbirth, the prognosis is favorable. The outcome of acute fetal hypoxia depends on the cause of the onset, the duration of the course and the timeliness of the treatment.

Prevention of fetal hypoxia includes:

Planning and preparing for pregnancy - identifying and treating chronic and gynecological diseases before pregnancy.
Close monitoring of pregnancy.
Regular visits to the obstetrician-gynecologist (once a month in the 1st trimester, once every 2-3 weeks in the 2nd trimester and once every 7-10 days in the 3rd trimester).
Registration and supervision in antenatal clinic(up to 12 weeks gestation).
Healthy and regular meals.
Compliance with sleep and rest, moderate physical activity.
Elimination of exposure to harmful factors.
Physical exercise aimed at training breathing. Singing lessons are also helpful.
Treatment concomitant diseases complicating the course of pregnancy.
The correct choice of method of delivery.

Questions and answers on the topic "Fetal hypoxia"

Can you please tell me if chronic hypoxia can be avoided during the second pregnancy and if so, how? During my first pregnancy, I had grade 2 hypoxia (they found it at 30 weeks, lay on the shelf, gave birth at 38 weeks through the CS, although they did not predict it). I am not pregnant for the second time yet, but we are already getting ready.
If you do not have placental insufficiency, then there will be no fetal hypoxia. You cannot avoid this in advance, it will be seen during the developing pregnancy.
I am 35 years old. I have a deadline of 31 weeks. By ultrasound 32-33. On last ultrasound said that the child does not have enough oxygen. What could be the reason for this, and what could be the consequences?
Most likely, you have been diagnosed with fetal hypoxia. This is not a disease, but a syndrome that accompanies another, underlying disease. Causes can be diseases from the mother (anemia, kidney, heart disease), and from the fetus (intrauterine infections, malformations, fetoplacental insufficiency). Fetal hypoxia can lead to its delay intrauterine development... Complex treatment is aimed at eliminating the underlying disease and improving placental circulation.
With fetal hypoxia, it is often recommended to drink oxygen foam. Does oxygen foam generally help with hypoxia? Or does it not cross the placental barrier? That is, it is useless for fetal hypoxia? It is said that during hypoxia, an oxygen-enriched sodium chloride solution is administered intravenously through a dropper. And that helps a lot. Your opinion?
This is more of a publicity stunt than a proven method.
In a month, the child was planned ultrasound nsg, the result is without pathologies. At scheduled examination a neurologist diagnosed hypoxia on the basis that an emergency cesarean was performed with a decrease in the fetal heart rate during childbirth, the presence of a tremor of the chin and arms with crying heavily... Prescribed cinnaresin, pantogam 1/4 2 times a day for a month and diacarb with asparkam 1/4 1 time a day with intervals of 2 days (for 2 weeks). After the treatment, the child became restless during feedings, increased sweating, irritability at external factors, lost appetite. When conducting nsg, an enlargement of the microscope of 3.5 mm and accumulation of fluid in the intrathecal spaces were revealed. Why could such a reaction occur, because at the first nsg there were no pathologies, all the indicators were normal?
Changes in nsg may just be associated with hypoxia during childbirth, because it was not for nothing that an emergency caesarean section was performed. It's just that at the first examination it did not appear so clearly, but now the signs of the problem are already more pronounced. You need to continue treatment and be under constant supervision of a neurologist until the situation calms down. Your task is to ensure that there is enough milk for feeding, calm atmosphere, walks in the open air. Well-formed care is the basis for recovery and normal development... Unfortunately, hyperexcitability- this is a feature of many babies after a cesarean section. But you can cope with it.

Hypoxia is a pathological condition characterized by oxygen deficiency. This condition is associated with an insufficient supply of oxygen from the outside or with violations of the utilization process at the cellular level.

Fetal hypoxia during pregnancy occurs as a result of prolonged lack of oxygen.

What is fetal hypoxia

During pregnancy, the need for oxygenation of the blood increases. A deficiency in this element can negatively affect both your body and the baby.

This pathological condition arises from different reasons... With a prolonged lack of oxygen, oxygen starvation develops.

The child's body compensates this disadvantage own resources, namely: increases heartbeat(for better blood flow).

There are two types of oxygen starvation. They differ in the duration and period of development of pathology. There are:

  1. Sharp appearance;

It rarely develops during pregnancy. Acute fetal hypoxia usually occurs during childbirth.

A factor that contributes to the development of this pathology is a chronic lack of oxygen earlier. This species threatens the life of the child.

  1. Chronic.

This type develops against the background of a complicated pregnancy, as a result of prolonged oxygen starvation. Subsequently, this can affect mental and physical development.

  • In chronic hypoxia, the fetus is in a state of oxygen starvation for a long time;

This condition occurs during severe pregnancy, non-compliance with the correct lifestyle during pregnancy, chronic stress of the expectant mother.

  • Chronic oxygen starvation is dangerous both in the early and late stages;

Therefore, it is so important from the very beginning of pregnancy to monitor your diet, monitor basic tests: blood, urine, and lead a healthy lifestyle.

  • Intrauterine fetal hypoxia in the early stages can cause developmental delays. Indeed, during this period, the formation of all internal organs occurs;
  • If oxygen deficiency appears at a later date, this can affect the nervous system of the fetus;
  • Fetal hypoxia at a later date can provoke growth retardation, poor adaptation of the child, anxiety and nervous disorders;

After birth, such a child may be extremely whiny, strive to stay in your arms and suffer from disturbed sleep.

  • Acute hypoxia that occurs during childbirth usually lasts from several minutes to several hours. If at this moment an emergency caesarean is not done, then this can cost the child's life;
  • Acute and prolonged oxygen deficiency leads to intrauterine asphyxia.

Therefore, it is so important to prepare well for childbirth, breathe correctly during contractions and not agree to additional stimulation measures.

Any stimulation knocks down natural course childbirth and no one will give you a guarantee how the child will react to a pill or injection.

Preparing for natural childbirth we are engaged in the online course Easy childbirth >>>

The best remedy for all unwanted diseases is prevention.

Healthy lifestyle, activities special gymnastics for pregnant, proper nutrition, - will help to avoid many pathological conditions and diseases.

Signs of hypoxia

How to determine fetal hypoxia?

A pregnant woman is responsible not only for her own health, but also for the health of her unborn child. Therefore, in this wonderful period expectant mothers especially carefully listen to their feelings.

But signs of fetal hypoxia in the early stages are difficult to detect.

Know! The doctor can suspect the development of pathology by looking at the results of a blood test. They will show signs of anemia (low hemoglobin).

  1. The reason for an unscheduled visit to the doctor may be feeling unwell pregnant;
  2. And at a later date - low fetal activity. If the child begins to move less, his jolts and movements are almost imperceptible, then this is a serious reason to consult a doctor.

The doctor, in addition to blood tests, prescribes an ultrasound scan.

  • Ultrasound examination allows you to determine the development of the fetus (its height, weight, volume). The condition of the placenta is also checked;
  • Intrauterine ultrasound procedure(dopplerography) allows you to assess the condition uterine blood flow... Circulatory disorders in the uterus and placenta - indicate a lack of oxygen;
  • Also, the doctor notes the degree of maturity of the placenta. The presence of pathology may indicate premature aging placenta walls that are too thin or thick;
  • In the third trimester, cardiotocography (CTG) is prescribed to diagnose the condition of the fetus. Fetal hypoxia according to CTG is determined by the number of heart beats (rare or, conversely, too frequent).

Symptoms and consequences of fetal hypoxia largely depend on the severity of the pathology.

Causes of hypoxia

The reasons for oxygen starvation can be different. Most often, hypoxia appears due to low hemoglobin (due to anemia. For this problem, there is an article on the site Low hemoglobin during pregnancy >>>)).

But there are other reasons as well. Namely:

  1. diseases of the blood, heart and blood vessels in a pregnant woman;
  2. the presence of infections or viruses in the mother's body;
  3. long lasting and severe toxicosis(see article Gestosis during pregnancy >>>);
  4. polyhydramnios;
  5. multiple pregnancy;
  6. Rh-conflict between mother and child;
  7. pathological location of the umbilical cord, cord entanglement;
  8. aging or abruption of the placenta prematurely;
  9. prolonged stress, depressive disorders;
  10. post-term pregnancy;
  11. long labor.

After the detection of pathology, the doctor prescribes treatment. Treatment depends on the severity of the hypoxia. In some cases, hospitalization may be required. But most often, home treatment is prescribed.

Prevention of hypoxia

How to avoid fetal hypoxia?

Stick following rules... This is something that is available to every woman and often requires only your time and a little constancy.

Learn more about how to behave on last weeks pregnancy, getting ready for childbirth, and dealing with anxiety before upcoming birth, we speak as part of the Five Steps to Successful Childbirth course >>>

  • First, oh bad habits you need to forget right away;

Smoking and alcohol can cause irreparable harm to your baby's health.

When a pregnant woman smokes, fetal vasospasm occurs. Nicotine contributes to the thinning of the placenta, increasing the risk of its detachment. It is difficult for oxygen to reach the uterus and the baby.

  • You need to walk in the fresh air as often as possible;

It is advisable that these walks be in a park or forest, where the air is cleaner. It is also recommended to constantly ventilate the room. Even in cold weather. Airing the room before bed is especially helpful.

  • Proper nutrition is very important for a pregnant woman;

But, in addition to avoiding stomach-heavy (spicy, fatty and sweet food), it is important that the diet of the expectant mother is healthy and varied.

Eating the same foods can lead to a deficiency important vitamins and nutrients.

Be sure to include in the diet foods rich in iron. These include: the liver, seaweed, apples, buckwheat, peas, pumpkin seeds, almonds, beans, prunes, raisins, dried apricots, chocolate.

  • We must not forget about water. Drinking enough water will help avoid swelling (read more about this in the article Swelling during pregnancy >>>);
  • Sports and gymnastics will help to avoid many pathologies and diseases;

The main rule is that the loads should be moderate. You can choose the sport that you like best. For example, yoga for pregnant women, swimming, etc.

  • But besides physical activity, it is important for the expectant mother to have a good rest. Healthy sleep allows you to restore energy, as well as get rid of worries and stress.

The consequences of hypoxia for a child can be very different. Better to pay more attention to prevention and tune in for the good.