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Violation of the uterine arteries during pregnancy, lagging in size. Uteroplacental blood flow in normal and pathological conditions

The placenta is responsible for the transfer of nutrition and oxygen from the mother to the fetus. Thanks to her, two complex vascular systems are united. One of them connects the placenta with the uterine arteries, and the other with the umbilical cord. In this case, the placenta serves as a barrier that protects the baby from viruses and harmful substances. It happens that during ultrasound, there is a violation of blood flow during pregnancy, which can affect the development of the baby.

Dopplerometry

This unusual name has a diagnostic procedure that detects any pathology of blood flow in the arteries and veins. As a result, a dopplerogram is built on specialized equipment, which displays the frequency difference between the sent and reflected signal. The study is carried out in a standard mode or with color mapping, that is, the movement of blood through the arteries is displayed in color. The latter option allows you to quickly and accurately detect even a slight violation of the uteroplacental blood flow.

Doppler is performed while lying on your back or side. At the same time, a more truthful result can be obtained on the side, since on the back of many pregnant women a tone begins, provoking various pathologies. The specialist covers the area under study with a gel and begins to drive the sensor over it.

This study is prescribed for all pregnant women together with the first (18-22 weeks) and second (32-34 weeks) screening. It can also be carried out in the interim, if there is evidence.

Causes of impaired blood flow

To identify a malfunction in the blood flow system, experts conduct an ultrasound scan with dopplerometry for women. This allows you to see defects in blood vessels, to track the amount of oxygen and nutrients entering the fetus.

Very often, expectant mothers are interested in why there is a violation of blood flow during pregnancy. The main reasons for this condition:

  • Woman's age (too early or, conversely, late).
  • Small gap between births.
  • Gestosis (late toxicosis during pregnancy).
  • Neoplasms in the uterus (for example, fibroids), myometrial pathology, endometriosis.
  • Diabetes.
  • Hypertension
  • Kidney problems.
  • Intrauterine infection due to viral diseases of a woman.
  • Multiple abortions or miscarriages.
  • Anemia (lack of iron).
  • Placenta previa.
  • Rhesus conflict.
  • Blood clotting problems leading to blood clots.

The degree of blood flow disturbance

At the moment, there are three degrees of pathology. The first degree is divided into two subspecies: 1A (violation of uteroplacental blood flow) and 1B (problems with blood circulation between the fetus and the placenta). In the second degree, there are problems with both systems ("uterus - placenta" and "placenta - fetus"). The third degree is given to those women who have serious circulatory complications.

The first stage of the disease can be adjusted with drugs, and as a result, a healthy child is born. In other cases, there is a risk of his perinatal death.

Types of placental insufficiency

If, when carrying a baby, a violation of blood flow is detected, then doctors usually make a diagnosis. During pregnancy, such a pathology occurs quite often and can be acute or chronic. The acute form can appear suddenly, at any time, as a result, the fetus experiences hypoxia and may die. This is possible with premature placental abruption, placental infarction, blood clots.

The chronic form is much more common in the acute form. It usually occurs after 13 weeks and appears in the third trimester. As a result, premature aging of the placenta occurs. Depending on the severity, the disease is compensated, decompensated, subcompensated, critical.

In the compensated stage, the baby continues to develop normally, since these changes are eliminated by the protective mechanisms of the female body. With decompensated pathology, he ceases to cope with problems, as a result of which the fetus has a growth retardation and the subcompensated stage of the disease leads to a delay in the development of the baby, as well as to his possible death. The most difficult form is considered to be critical placental insufficiency. It does not occur very often, but its onset leads to the inevitable death of the child.

The main symptoms of the disease

Depending on the type of blood flow disorder, different symptoms may appear. The compensated placental does not manifest itself in any way, therefore, they will only find out about it during an ultrasound scan. With an acute and decompensated form, changes appear in the baby's movements: he moves either too much or very little. In this case, it is important to monitor this indicator (the fetus must move at least 10 times per day).

Additional signs may include slow abdominal growth, lack or excess of amniotic fluid. It will not be possible to monitor this on your own, so you need to visit a doctor so that he monitors changes in measurements. It happens that a violation of blood flow accompanies preeclampsia - late toxicosis during pregnancy. To the existing symptoms, an increase in pressure, a sharp weight gain, edema, and protein excretion in the urine may be added.

The most dangerous sign of placental insufficiency is the appearance of blood from the birth canal associated with placental abruption. In this condition, only an ambulance of specialists will help.

Pathology treatment

If a woman has an increased or tendency to thrombosis, most often she has a violation of blood flow. During pregnancy, treatment is prescribed only by a doctor, because you will have to take serious medications. The most commonly prescribed drugs are Curantil, Trental and Hofitol. They thin the blood and improve its movement through the arteries.

Most often, pregnant women are prescribed "Curantil", which has been used in obstetrics for more than 15 years. The drug does an excellent job with its tasks - it normalizes blood circulation due to its thinning, prevents blood clots from forming, helps to form new vessels, and increases immunity.

Also in demand is "Trental" - a drug that is similar in action to "Curantil". However, it has serious advantages: the drug does not dilate the blood vessels of the heart and continuously releases the active ingredient for 12 hours.

It happens that a woman has a slight disturbance of blood flow during pregnancy. In this case, treatment is carried out with "Hofitol" - a preparation with mineral and plant components (for example, the juice of the leaves of a field artichoke). It has a mild diuretic effect and does not harm the liver.

Treatment methods for different degrees of pathology

The first degree of the disease involves taking drugs that improve blood circulation. Also, doctors will conduct Doppler and cardiotocography in dynamics. Research should be carried out 1-2 times every 7 days. With positive dynamics, the woman will continue to carry the baby until he is born. If the indicators deteriorate, it is necessary to conduct daily tests to prevent irreversible changes and to carry out an emergency cesarean section in time. With the normal development of the fetus, childbirth can take place naturally.

Grade 2 blood flow impairment during pregnancy is also treatable. Usually, the same drugs are used as in the first case, but the woman will be offered hospitalization. Doctors will monitor changes in the body and, if necessary, perform an early delivery.

The third degree is not treated in any way, since irreversible consequences begin to appear. In this case, specialists do not risk the child's life and prescribe an emergency operation.

Prophylaxis

Any woman can do so that the baby develops and grows without complications. To do this, she will have to monitor her diet: it should contain a lot of vitamins, minerals, proteins and other important substances. If a pregnant woman does not suffer from edema, then she must drink at least 1 liter of liquid daily (better than water).

It is very important to control your weight - the increase in carrying a baby can be a maximum of 10 kg. Some women need prophylaxis with medication to improve circulation between mother and fetus. It will prevent impaired blood flow during pregnancy. It should be remembered that the correct method of childbirth and the timely connection of drugs will help to preserve the child's life.

Mother and child are closely linked throughout pregnancy: the woman's body not only provides a place for the baby, but also provides him with the necessary nutrients, vitamins, and elements. The placenta is of great help in this - it is she who takes over most of the work: it controls gas exchange, protects against bacteria, microbes and even the mother's immune cells, and also provides nutrition to the fetus and the production of certain hormones that support the normal course of pregnancy. Unfortunately, doctors diagnose every fourth pregnant woman with a violation of blood flow in the mother-placenta-fetus system. It is not surprising that women are worried about the consequences of impaired blood flow during pregnancy and how they will affect the life and health of the child.

How it works?

The movement of blood through the blood vessels is carried out in two circles of blood circulation - large and small. A pregnant woman has 3 circles of blood circulation: an additional blood circulation system appears between the woman and the placenta. The child, in turn, also has its own, separate circulatory system, which is associated with the placenta. The blood of the mother and the child never mixes, and the entire exchange of nutrients, oxygen takes place in the placenta.

Impaired blood flow

Violation of blood flow can manifest itself anywhere in the interaction of blood circulation between the mother and the fetus, has 3 degrees of severity:


  • 1st degree... Failure occurs only in ONE circulatory system:
  1. Uteroplacental (1A)
  2. Fetal-placental (1B)

Disturbances in the work of blood flow of the 1st degree are considered the easiest, since at this stage they do not affect the development of the child. With early detection, this disorder is successfully corrected by taking medication, and re-examination after the end of the course of treatment. However, if adequate treatment is not carried out on time, then after 3-4 weeks the condition will worsen and move to the next level.

  • 2nd degree characterized by disorders of blood movement in TWO systems simultaneously: in the fetus and in the uterus. At this stage, there are still no pathological changes in the bloodstream systems. If untreated, the child's condition can quickly deteriorate (within 1 week) and go to grade 3.
  • Grade 3... A critical condition of blood flow, in which the supply of nutrients and oxygen to the fetus is significantly impaired. Fetal hypoxia (acute lack of oxygen) is often manifested, which affects the development of the child and his health in the future.

How to recognize?

Unfortunately, it is impossible to independently recognize blood flow disorders without special means. This dysfunction can be diagnosed only after a Doppler examination (with an ultrasound machine). Also, a lag in the development of the fetus, a slow increase in the circumference of the abdomen, a discrepancy between the height of the fundus of the uterus and the expected period of pregnancy can speak of this problem. Another sign is hypoxia, its presence is evidenced by the vigorous activity of the child, and then a noticeable decrease in the intensity of movements.


Treatment

The first degree of blood flow dysfunction can be corrected with drugs (Actovegin, Curantil, Magne-B6, No-shpa, Trental, Ginipral, Isoptin, etc.). After the treatment, the pregnant woman is hospitalized without fail for a period of 36 weeks for antenatal care. Natural childbirth is possible only with careful supervision by the medical staff.


In the second degree, complex treatment is aimed at stopping the further development of blood flow disorders, accelerating the maturation of the lungs and maximizing the intrauterine development of the fetus until the time when premature birth will not threaten the child's life. Doppler is done every 3-4 days. Childbirth takes place by caesarean section.


In the third degree, the efforts of doctors are aimed at establishing the causes of hypoxia and its treatment. If the gestational age reaches 37 weeks, then a cesarean section is performed. In the case when the pregnancy is premature and there is a threat to the life of the child with premature birth, the decision is made based on the situation. The child's condition is monitored in dynamics using dopplerometry constantly throughout the day and night. If the condition worsens, an emergency caesarean section is performed.

What is the reason?

Disruption in the work of blood flow can be caused by a variety of reasons, and is often a consequence of these diseases:

  1. Diabetes mellitus, hyperthyroidism, hypothyroidism and other neuroendocrine diseases;
  2. Pneumonia, asthma and other diseases of the respiratory system;
  3. Hypertension, hypotension, heart disease and other diseases of the cardiovascular system;
  4. Pyelonephritis, renal failure and other diseases of the kidneys, urinary system.

Prophylaxis

With this pathology, there is no effective prevention, however, adherence to sleep and rest, adequate nutrition, moderate physical activity, walking in the fresh air can significantly reduce the risk of such complications.

Observation by the attending physician, adherence to all his recommendations, taking prescribed medications and passing all examinations and tests - will help not only avoid possible problems, but also timely identify pathology and carry out effective correction.

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