Interesting Facts 

What causes fetal hypoxia? Reasons for the development of hypoxia. The consequences of acute hypoxia

What is fetal hypoxia

While the baby is in the womb, his lungs are not working yet. They are filled with liquid, and although they sometimes breathe, oxygen does not flow through them.

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

Fetal hypoxia during pregnancy

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

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

Hypoxia during labor

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

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

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

Possible causes of hypoxia

From the mother's side:

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

From the side of the fetus:

  • Congenital malformations;
  • Intrauterine infections;
  • Placental insufficiency;

During childbirth:

  • Abnormal presentation of the fetus (pelvic, oblique);
  • Multiple births (twins, triplets);
  • Prolapse of the umbilical cord;
  • other.

Signs of fetal hypoxia, how to determine fetal hypoxia?

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

After 18–20 weeks, when the baby begins to move with might and main in the uterus, the mother may suspect hypoxia due to a decrease in its activity. If fetal movements become sluggish and less frequent, see a doctor for examination.

Signs of hypoxia during examination:

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

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

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

How to deal with hypoxia

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

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

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

In more serious cases, according to the decision of the doctor, hospitalization in a maternity hospital and treatment with medications is necessary. To do this, apply:

  • Curantil
  • Actovegin
  • Trental
  • Oxygen cocktail

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

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


Intrauterine fetal hypoxia is a condition that occurs due to a lack of oxygen. The disease is recorded in 10% of all babies and is most often detected after 20 weeks. Chronic hypoxia can cause intrauterine growth retardation and serious health problems. Acute hypoxia without emergency treatment leads to fetal death.

Although acute and chronic hypoxia are similar in name, they should be considered separately. In clinical practice, chronic oxygen deficiency is most common. Acute hypoxia can be a consequence of chronic or other causes that occur suddenly during pregnancy or childbirth.

Causes of hypoxia

During intrauterine development, the baby receives oxygen and nutrients through the placenta through the umbilical cord. The child cannot breathe on his own. The lungs open only after birth, at the moment when the newborn takes its first breath. Any pathology of the placenta can lead to a decrease in oxygen supply and the appearance of serious problems during intrauterine development.

Chronic hypoxia develops gradually. The cause of this phenomenon can be a variety of conditions, both on the part of the woman and on the part of the fetus. In some cases, it is not possible to find out the leading provoking factor. Usually, we are talking about several phenomena at once that negatively affect the development of the fetus and interfere with the supply of oxygen to the baby.

Maternal factors in the development of hypoxia:

  • diseases of the cardiovascular system (including hypertension, hypotension, heart defects, which result in a violation of microcirculation in the placenta);
  • kidney disease;
  • anemia (lack of erythrocytes and hemoglobin does not allow for the full delivery of oxygen to the fetus;
  • pathology of the blood coagulation system, leading to its thickening;
  • diseases of the respiratory system (including bronchitis, pneumonia, bronchial asthma due to the development of respiratory failure);
  • any conditions accompanied by fever;
  • complications of pregnancy (gestosis, uterine hypertonicity).

Fetal risk factors:

  • intrauterine infections;
  • congenital malformations;
  • hemolytic disease;
  • pathology of the umbilical cord;
  • lack of water;
  • pathology of the placenta;
  • overburdening;
  • violation of blood flow in the placenta and umbilical cord vessels (as a result of various factors).

In fact, any pathology that disrupts the normal course of pregnancy and fetal development can lead to hypoxia.
It is important to understand: chronic fetal hypoxia does not occur in isolation without placental insufficiency. First of all, the supply of oxygen through the placenta is disrupted, and only after a certain time do signs of hypoxia appear. An exception may be fetal malformations, when there are certain obstacles to the normal supply of oxygen to the brain. In this case, the placenta functions normally, but the baby still suffers from hypoxia. You can find out the reasons for this complication by performing an ultrasound scan or cardiotocography.

Acute fetal hypoxia occurs mainly during childbirth against a background of various reasons:

  • weak or overly vigorous labor;
  • prolapse or clamping of the umbilical cord loops;
  • entanglement with an umbilical cord;
  • clinically narrow pelvis;
  • protracted or rapid labor;
  • premature placental abruption;
  • rupture of the uterus, including the scar, etc.

Acute hypoxia can occur suddenly or become a natural outcome of chronic pathology. During pregnancy, placental abruption and massive bleeding can also lead to acute hypoxia.

Symptoms

There are no specific symptoms to recognize hypoxia. The only sign that an expectant mother should be guided by is a change in fetal activity. Chronic hypoxia is indicated by an increase in fetal movements (in comparison with its usual activity). Thus, the baby reacts to a lack of oxygen, which primarily affects the brain and other parts of the nervous system.

Fetal movements can be monitored after 24 weeks. Until this time, they are weakly felt, and a change in fetal activity cannot be a diagnostic criterion. In the early stages, this symptom does not make sense at all. Until 18-20 weeks, a woman, as a rule, does not feel fetal movement.

A slowdown in fetal activity is an even more unfavorable symptom and indicates the progression of hypoxia. The complete absence of movements may indicate acute hypoxia and the probable death of the fetus. If the baby does not make itself felt for more than 6 hours in a row after 24 weeks, you should see a doctor as soon as possible.

Consequences of hypoxia

The body of a growing fetus has excellent ability to compensate for emerging problems. It is no coincidence that a baby's heart rate is 120-160 beats per minute, which is twice that of an adult. Such a heart rate plus the special structure of fetal hemoglobin create optimal conditions for all the baby's organs to be adequately supplied with oxygen until the very birth. If oxygen delivery is disrupted, the heart rate increases - and thereby the lack of a vital element is compensated.

Unfortunately, the compensatory possibilities of the fetus are not endless. Resources are depleted, and the heart can no longer cope with the load. The heart rate slows down, there is a lack of oxygen - hypoxia. Under conditions of hypoxia, the body primarily strives to provide valuable oxygen to key organs - the brain, heart and kidneys. The rest of the organs - intestines, muscles, skin - suffer from hypoxia. In particular, skeletal muscles relax, their tone changes. The smooth muscles of the intestine also suffer from hypoxia, due to which the sphincter relaxes and the active release of meconium, the original feces, into the amniotic fluid.

At the initial stages of hypoxia, the fetal nervous system does not suffer, but all resources have their limits. With a prolonged lack of oxygen, neurons die. The development of the fetus slows down, and the complex structures of the brain are affected in the first place. The longer the exposure to hypoxia, the more severe the consequences for the fetus will be.

Moderate and short-term hypoxia does not affect the child's health too much. The disorders arising from this condition are well corrected in the first year of life. Prolonged hypoxia is accompanied by cerebral ischemia and circulatory disorders. In the internal organs, foci of necrosis appear, which leads to irreversible consequences. Severe hypoxia can cause fetal death in utero or during childbirth, lead to severe health problems - physical and mental.

Diagnostics

To identify pathology, the following methods are used:

Ultrasound

Allows you to assess the general condition of the fetus and identify the likely causes of hypoxia. Particular attention is paid to the location and thickness of the placenta. Thickening of the placenta and the appearance of calcifications in it ahead of time indicates that this organ is not coping with its function. Placental insufficiency develops, which means that it is not far from fetal hypoxia.

During ultrasound, you can also determine the transparency of the amniotic fluid. Normally, up to 20 weeks, the waters are transparent, and only in the second half of pregnancy a suspension appears in them - particles of desquamated epithelium and elements of a cheese-like lubricant.

During the ultrasound scan, the size of the fetus is also assessed, and their compliance with the gestational age is determined. If the baby does not reach the norm, they speak of a delay in its development (SDRP). This condition also indirectly indicates fetal hypoxia.

Dopplerometry

It is carried out together with an ultrasound scan starting from a period of 18 weeks. Normally, the blood flow in the vessels of the umbilical cord, uterus and placenta should be adequate to the gestational age. If the blood flow is impaired, this clearly indicates the development of placental insufficiency and indicates that the fetus does not receive oxygen in the required volume. Violation of blood flow is always accompanied by fetal hypoxia and can lead to a delay in its development.

Cardiotocography

- the leading method for detecting fetal hypoxia. During the study, it is assessed:

  • Fetal heart rate;
  • heart rhythm;
  • rhythm variability.

The result obtained is determined in points according to Fisher (adaptation according to Savelyeva):

  • 8-10 is the norm;
  • 5-7 - fetal hypoxia;
  • up to 5 - a critical condition of the fetus.

A score of 7 is already an alarming sign. Based on the data obtained, a diagnosis is made and a specific treatment can be prescribed. It is important to understand that a one-time bad result is not a sentence. Perhaps the baby was just asleep at the time of CTG. With CTG of 6-7 points, the study should be repeated every other day. CTG of 5 points or less is a reason for emergency hospitalization in a maternity hospital.

Tactics for fetal hypoxia

When chronic fetal hypoxia is detected, a specific therapy regimen is selected. In mild cases, outpatient treatment in a antenatal clinic is possible. The doctor can also offer the patient a day hospital. In difficult situations, round-the-clock supervision in a specialized department is shown.

In the treatment of chronic hypoxia, non-drug practices are actively used:

  1. Active walks in the fresh air (at least 1 hour a day in good weather).
  2. Respiratory exercises to relax the tone of the muscles of the uterus and abdominal wall.
  3. Aqua aerobics (including in specialized groups), as well as free swimming.
  4. Yoga for pregnant women or any gym designed for expectant mothers.
  5. Giving up hard work.
  6. Refusal from stress - less worries, more positive.
  7. Nutrition balanced in terms of basic mineral elements and vitamins.
  8. Quitting bad habits (smoking and alcohol are prohibited).

It is very important to find the cause of hypoxia and eliminate it. For this purpose, sanitation of foci of chronic infection is prescribed, measures are taken to normalize blood flow in the placenta. As a drug therapy, various agents are used that stimulate blood flow in the vessels of the placenta and umbilical cord. The choice of a specific drug remains with the doctor.

Currently, much attention is paid to the correction of hemostasis disorders. It is believed that the pathology of the blood coagulation system is one of the key causes of impaired blood flow, fetal hypoxia and premature birth. The expectant mother is recommended to take a hemostasiogram. If violations are detected, correction is carried out with antiplatelet agents and anticoagulants.

Reducing the tone of the uterus is another important point in the treatment of fetal hypoxia. If a woman has a threat of premature birth, she is advised to rest, tocolytics and magnesium preparations are prescribed. All this therapy helps to relax the uterus and improve blood flow in the placenta, which means it reduces the manifestations of hypoxia.

Childbirth with chronic hypoxia can go through the natural birth canal, if the condition of the fetus remains stable. During childbirth, constant CTG monitoring is carried out. If the baby's condition worsens, a cesarean section is indicated. In acute hypoxia, the operation is performed immediately.

Prophylaxis

The following recommendations will help prevent the development of intrauterine hypoxia:

  1. Rational, balanced nutrition.
  2. Quitting bad habits (especially smoking, including passive smoking).
  3. Timely night sleep, rest during the day as needed.
  4. Adequate physical activity (restriction of hard work, but optimal physical activity with good health).
  5. Weight and blood pressure control.
  6. Timely therapy for any acute and chronic diseases.
  7. Competent treatment of complications arising during pregnancy.

At the slightest suspicion of fetal hypoxia, you should consult a doctor.

Fetal hypoxia can appear at different times of intrauterine development and be characterized by varying degrees of oxygen deficiency and consequences for the child's body. Developed in the early stages of pregnancy, it causes defects and a slowdown in the development of the embryo. In the later stages, it is accompanied by a delay in fetal growth, damage to the central nervous system and a decrease in the adaptive capabilities of a newborn baby.

The lungs of the fetus are not yet working, oxygen enters it through the placenta, which in turn receives it from the woman's body. If this process is disrupted, fetal hypoxia develops. In this regard, there are two main types of hypoxia:

Chronic hypoxia appears during the period of gestation and can develop over a long time.

Acute hypoxia can occur during difficult labor.

What is the danger of fetal hypoxia

Minor hypoxia usually does not affect the health of the child, but in a severe form, oxygen deficiency can lead to rather dangerous disruptions in the functioning of the fetus. The degree of danger depends on the period of its occurrence.

In the early stages of pregnancy, a lack of oxygen leads to a slowdown in the development of the baby and the appearance of various abnormalities. From 6-11 weeks of gestation, hypoxia can disrupt the maturation of the embryonic brain structures, slow down the maturation of the central nervous system and the functioning of blood vessels. All this jeopardizes the normal functioning of the child's brain.

In later periods, hypoxia leads to a delay in the development of the baby, his growth, affects his nervous system and reduces the adaptive capacity in the postpartum period. A child born under conditions of hypoxia can face various neurological disorders - from minor ones (restless sleep, poor appetite, moods, convulsions) to severe mental disorders and serious somatic abnormalities.

Acute fetal hypoxia can cause premature birth, weakness in labor and even death of the child.

In addition, hypoxia during childbirth is fraught with asphyxia - the inability of the newborn to take the first breath. In some cases, such children may need artificial ventilation.

Causes of fetal hypoxia

Intrauterine fetal hypoxia can be justified by various reasons. This is, as a rule, a consequence of abnormalities in the body of the woman herself, the fetus or the placenta, through which oxygen is supplied to the child.

Mom's pathologies that can cause hypoxia:

  • Bad habits. Smoking is especially dangerous (passive as well), since nicotine constricts blood vessels, which means that blood circulation in the body of a pregnant woman is impaired.
  • Anemia is low hemoglobin. It disrupts the delivery of oxygen to the tissues of the body. Anemia has three degrees of severity, and the severity of possible deviations in the child depends on this.
  • Diseases of the cardiovascular system(congenital or acquired heart disease, myocardial infarction, hypertension). They cause vasospasm, which impairs the blood supply to the fetus.
  • Bronchial asthma, pulmonary emphysema, chronic bronchitis and other diseases of the respiratory system. They cause respiratory failure, as a result of which hypoxia develops in the woman herself, and therefore in her baby.
  • Kidney disease(chronic renal failure, amyloidosis, etc.).
  • Diabetes mellitus and other abnormalities in the work of the endocrine system.
  • Gestosis(late severe toxicosis).
  • Frequent stress.


Fetal diseases causing hypoxia:

  • Congenital malformations.
  • Intrauterine infections(herpes infection, toxoplasmosis, chlamydia, mycoplasmosis and others).
  • Hemolytic disease- incompatibility of the blood group of the mother and the child, as a result of which the woman's body considers the fetus to be a foreign body and tries to reject it.

Directly during childbirth, hypoxia can occur for the following reasons:

  • Abnormal presentation of the fetus (pelvic or oblique).
  • Prolonged squeezing of the head in the birth canal.
  • Multiple births.
  • Postponing pregnancy.
  • Prolapse of the umbilical cord.
  • Repeated and tight entanglement of the baby with the umbilical cord.
  • Placental abruption.
  • Weak labor activity.
  • The discrepancy between the width of the woman's birth canal and the size of the child.

Diagnostics of hypoxia: independent and medical

In the early stages, fetal oxygen deficiency is almost impossible to detect. It can only be assumed by anemia and other diseases of a pregnant woman.

Starting from 18–20 weeks, intrauterine fetal hypoxia can be detected independently. It is manifested by changes in the child's motor activity. At first, his anxiety and increased frequency of movements are noted, then, with a longer lack of oxygen, movements, on the contrary, suspiciously weaken, become lethargic and more rare. Therefore, it is important to monitor your baby's activity on a daily basis. There is a so-called technique 10. From the very morning, observe the movements of the crumbs. There should be 10 or more of them in 12 hours. This does not mean every single movement, but episodes of activity. They usually last 1–2 minutes. If there is less movement, you should immediately consult a doctor.

Modern examination methods help to determine whether the fetus is suffering from a lack of oxygen or not. The most important ones are as follows:

  • Auscultation- listening to the baby's heartbeat with a stethoscope. The doctor evaluates the heart rate, rhythm, the presence of murmurs, heart sounds. At the initial stage, the fetal heart rate increases, the tones are muffled. With prolonged oxygen starvation, the fetal heart rate slows down.
  • Cardiotocography (CTG)- a method for diagnosing the condition of the fetus using a cardiac monitor, which shows an analysis of the fetal heart rate and its motor activity. CTG is performed from 30-32 weeks of pregnancy and can also record uterine contractions. CTG is done directly during childbirth, since a violation of the child's cardiac activity is the main indicator of hypoxia.
  • Ultrasound examination (ultrasound)- fixes possible delays in the development of the fetus, analyzes its growth, size and weight in accordance with the norms. In addition, ultrasound studies amniotic fluid, their volume, composition and color, as well as the presence of oligohydramnios or polyhydramnios, which can cause hypoxia.
  • Dopplerometry- studies the nature of blood flow in the vessels of the placenta and umbilical cord, a violation in which may be a sign of oxygen deficiency.
  • Amnioscopy- examination of the fetal bladder using an endoscopic device inserted into the cervical canal. It is used to study the state of amniotic fluid. In favor of fetal hypoxia is evidenced by the admixture of meconium in the amniotic fluid and their greenish color.

Immediately after childbirth, the doctor can easily determine the presence of hypoxia in a newly born baby. The presence of oxygen starvation in this case will be indicated by:

  • Pale, bluish skin color.
  • Labored breathing.
  • Weak cry and no crying.
  • Weak muscle tone.
  • Weak reflexes.
  • Low heart rate.

Such a child often needs intensive care.

How is intrauterine fetal hypoxia treated?

Hypoxia does not appear suddenly, regular visits to the doctor leading a pregnancy can prevent or minimize it. It is important that pregnancy management is carried out taking into account risk factors and timely monitoring of the condition of the fetus and woman.

The main task of the doctor is, first of all, even in the early stages of pregnancy (and ideally when planning it) to eliminate all the causes that can cause hypoxia. If hypoxia has already been detected, it is possible that a pregnant woman is waiting for treatment in a hospital or at home, if the condition allows. The most important condition in this case is to provide her with complete rest and timely intake of medications.

The main thing that should be directed to the treatment of hypoxia is the restoration of normal blood supply to the fetus. To do this, the expectant mother is prescribed bed rest, with a predominant position on the left side (this contributes to better blood supply to the uterus) and drugs that improve blood flow to the placenta and normalize the metabolism between mother and child, as well as treatment of major diseases due to which hypoxia can to appear.

With slight hypoxia, the following are most often prescribed:

  • Oxygen inhalation.
  • Glucose with ascorbic acid and insulin.
  • Inhalation with alkaline solutions (for example, a solution of baking soda with water or alkaline mineral water).
  • Sessions of staying in a pressure chamber.

With hypoxia, exercise is very useful for pregnant women. However, if you did not play sports before pregnancy, you should not rush to the simulators. Consult a doctor and, if there are no contraindications to activity, choose a moderate load for yourself. Do yoga, Pilates, swimming, water aerobics - all these sports improve blood circulation throughout the body, including in the placenta, from which the amount of oxygen supplied to the baby increases. It is better to attend classes with an instructor who will closely monitor you, taking into account the duration of the pregnancy and the corresponding condition.

Prevention of intrauterine fetal hypoxia

Preventing the development of fetal hypoxia requires a woman to prepare responsibly for pregnancy. Rejection of bad habits, proper nutrition, treatment of diseases of the reproductive system and existing chronic diseases at the stage of pregnancy planning can minimize the risks of hypoxia.

It is recommended to engage in the prevention of hypoxia from the very beginning of pregnancy. The expectant mother should give up bad habits, lead a healthy lifestyle, avoid overwork, but the most important thing is to walk as much as possible (if once a day, then at least 2 hours, if such long walks are not possible, then you can walk a little 2-3 times a day). A walk (ideally outside the city) stimulates the entire body, but has a particularly positive effect on the respiratory and cardiovascular systems. Inhaled air improves metabolism in the placenta and reduces the likelihood of hypoxia. In addition to walking, do not forget to regularly ventilate your apartment.

Also, for the prevention of hypoxia, it is very important to monitor the level of iron and the possible occurrence of anemia. To do this, you need to eat right (include iron-containing foods in the diet: beef, buckwheat, etc.) and take the necessary medications and vitamins as directed by your doctor.

In order to prevent the development of acute fetal hypoxia, it is important to choose the right method of delivery. If you are more than 28 weeks pregnant, your doctor may order an emergency delivery by caesarean section. In addition, childbirth takes place with compulsory cardiac monitoring, which allows you to monitor the child's condition and, if necessary, change the tactics of labor management.

A baby born with hypoxia may need resuscitation. In the future, children who develop under conditions of hypoxia should be especially carefully monitored by a neurologist, who prescribes a course of treatment, physiotherapy exercises, massage, sedatives, etc.

The main thing to remember is that your health is the health of your unborn child. Take care of yourself and carefully monitor your condition and the condition of the baby growing inside you!

Vulnerabilities

The nervous system is one of the most oxygen-dependent, and if the growing fetus does not have enough oxygen, this primarily affects the nervous tissue. At the same time, while the child's body intensively supplies oxygen to the nervous system and heart, other organs suffer - the lungs, gastrointestinal tract, skin, etc. Therefore, with prolonged hypoxia, pathologies of almost all fetal organs are possible.

Intrauterine fetal hypoxia is a dangerous process that, unfortunately, is very common. The consequences of hypoxia can negatively affect the development of the fetus and the activity of its internal organs. The life and health of the unborn child largely depends on timely diagnosis and treatment.

Waiting for a miracle

Pregnancy is a very exciting and joyful time for every woman. But to the joyful anticipation of the birth of a baby, anxiety for his health is added. The mother-to-be bears a heavy burden of responsibility. For nine months a new life develops and grows in it. The health of an unborn baby directly depends on the well-being of his mother.

There are many guidelines on how to manage your health during pregnancy. This applies to nutrition, lifestyle, emotional stress and much more. Failure to follow these simple rules can lead to adverse consequences and damage the health of the fetus.

One of these consequences can be intrauterine hypoxia, which entails disturbances in the development of the fetus and, in some cases, the fading of pregnancy. To avoid this, the expectant mother needs to carefully study the risk factors that lie in wait for her during pregnancy, and try to prevent their occurrence.

What is hypoxia

"Hypoxia" is an ancient Greek word that literally translates as "low oxygen". This term denotes oxygen starvation, which is experienced by the body or its individual organs as a result of exposure to certain factors.

With prolonged oxygen starvation, irreversible morphological processes occur in the human body. They change the structure of tissues and organs and disrupt their functional abilities. With oxygen starvation of the fetus, the process of formation of internal organs is slowed down and disrupted, the child can be born with a lag in the development of vital systems or die. These are the consequences of intrauterine hypoxia. The heart, kidneys, liver and central nervous system are most strongly affected by hypoxia.

Oxygen deficiency can accompany any disease or arise as an independent process, entailing defects of internal organs. For this reason, hypoxia cannot be classified as a disease, it is a pathological process, the same as inflammation or dystrophy.

Symptoms of fetal hypoxia

It is noted that in the first three months of pregnancy, oxygen deprivation develops quite rarely. Most often, this can happen in the second and third trimester. This is due to the fact that with the growth of the fetus, an increase in its demand for oxygen also arises, and under some unfavorable circumstances the body of a pregnant woman cannot cope with this task.

Oxygen deficiency in a baby is difficult to identify without diagnostic tests, especially in early pregnancy. But there are some signs of intrauterine hypoxia, which should be an alarming signal for the expectant mother.

The first thing to look out for is fetal activity. Approximately ten movements per day are considered the norm. In the initial stages of hypoxia, the baby begins to feel discomfort, therefore, is overly active. With a longer oxygen deficiency, the amount of perturbation decreases. In addition, intrauterine hypoxia can be characterized by frequent fetal hiccups.

If the deviation in the number of movements from the norm and frequent hiccups are not associated with the physical exertion of the expectant mother or being in an uncomfortable position, it is required to consult a specialist as soon as possible, who will identify the cause of this fetal behavior and, if necessary, prescribe treatment.

Causes of occurrence

The reasons for intrauterine fetal hypoxia may be different. These include diseases that a pregnant woman suffers from, pathologies of the placenta, infection,

Of the diseases of the mother leading to fetal hypoxia, the following can be distinguished:

  • anemia;
  • disturbances in the work of the cardiovascular system;
  • respiratory diseases;
  • diabetes.

In addition, the health of the baby is affected by the bad habits that the expectant mother suffers from. Prevention of intrauterine hypoxia includes complete cessation of smoking and alcohol. Any deviation from the generally accepted norms of pregnancy can lead to oxygen starvation of the fetus. Such deviations can be detachment and premature aging of the placenta, prolonged fetal life, or increased uterine tone.

Another factor that entails is the incompatibility of the Rh factor of the mother and the child. Such incompatibility can lead to hemolytic disease of the fetus, which is often accompanied by hypoxia. In addition to the above factors, the influence can have a mechanical effect on the fetus - entanglement with the umbilical cord, squeezing the head during childbirth, and so on.

The causes of intrauterine hypoxia can also become the causes of other, no less serious complications. To avoid an adverse effect on the development of the fetus, the expectant mother needs to be monitored by a qualified specialist throughout the entire period of pregnancy.

Types of fetal hypoxia

Depending on how long oxygen starvation lasts, intrauterine hypoxia has two forms: acute and chronic. Acute hypoxia is characterized by a sharp decrease in supplied oxygen. The most common acute form occurs during childbirth or with profuse uterine bleeding. Chronic intrauterine hypoxia forms over a long period of time, gradually disrupting the processes of fetal development.

The degree of progression of oxygen deprivation

There are three stages of development of fetal hypoxia. At first, the fetus, having not received the required amount of oxygen, tries to compensate for its lack. The first degree is to compensate for the lack of oxygen. In the baby's body, changes begin to occur aimed at increasing the volume of incoming oxygen. The level of a hormone that increases the tone of blood vessels, cortisol, rises. An increased level of cortisol stimulates an increase in the volume of blood that circulates through the vessels and an increase in the heart rate. The composition of the blood changes: the level of hemoglobin and erythrocytes increases. In addition, there is an increased activity of the baby. He begins to move more intensively and make breathing movements, despite the closed glottis.

At the second stage of partial compensation, the body's protective functions are determined by the priority organs that are supplied with oxygen in the first place. These organs are the heart and the brain, respectively, other organs (kidneys, lungs, gastrointestinal tract) receive oxygen-poor blood, which leads to disruptions in their development and work. Lack of oxygen also leads to the breakdown of glucose. This contributes to a decrease in the supply of energy in the cells of the body and metabolic disorders.

Chronic intrauterine fetal hypoxia also has a third stage of progression - decompensation. Outwardly, the stage manifests itself as a decrease in fetal activity and a decrease in heart rate. The work of protective mechanisms aimed at providing organs with oxygen fails. Cortisol is produced in insufficient quantities, so the blood flow slows down and decreases. The blood is saturated with carbon dioxide, blood clotting is impaired, which leads to the formation of blood clots and bleeding.

Diagnostic measures

Methods of instrumental diagnostics help to determine the presence and degree of oxygen starvation. The first such method is cardiotocography (CTG). This diagnostic method is completely safe. The cardiotocography apparatus continuously records the fetal heart rate and uterine contractions. A tachogram is displayed using an ultrasonic graph. This is a graph that reflects the number of contractions of the heart muscle in a given period of time. measures fluctuations in pressure and uterine tone, displaying a hysterogram - a graph of the muscle activity of the uterus. CTG counts the number of movements and allows you to track the dependence of the heart rate on the activity of the fetus.

Starting from the twentieth week of pregnancy, an ultrasound examination with Doppler ultrasound is possible. This method is aimed at examining the blood flow from the mother to the placenta and from the placenta to the fetus and allows detecting disorders of the uteroplacental circulation. Using this diagnostic method, you can also determine the quality of amniotic fluid.

In addition to the above methods, a specialist listens to the fetal heart to assess its work using an obstetric stethoscope. However, this method is inaccurate, therefore, if a heart anomaly is suspected, the doctor directs the pregnant woman to undergo CTG and ultrasound.

Treatment

Treatment of intrauterine hypoxy requires monitoring of the pregnant woman in the hospital. The woman is provided with complete rest and a therapeutic method of treatment is prescribed, which is aimed not only at enriching the blood with oxygen, but also at identifying the true cause of hypoxia. As a rule, abnormalities in the course of pregnancy, such as intrauterine fetal hypoxia, are the consequences or symptoms of a disease.

The doctor prescribes drugs for the pregnant woman that reduce the viscosity of the blood, improve blood flow from the mother to the placenta and normalize the metabolism between the mother and the fetus. The appointment of other drugs and procedures depends on the cause of hypoxia, if identified, and is aimed at eliminating this cause.

With positive dynamics, the patient is discharged and given recommendations for the prevention of hypoxia. These include walking in the fresh air, reducing physical activity, quitting bad habits and following certain dietary rules. If the treatment was unsuccessful, and oxygen deficiency persists, prompt extraction of the fetus is required. If the gestation period exceeds twenty-eight weeks, the doctor prescribes an operation - a cesarean section.

Prophylaxis

There are a number of simple guidelines that can be followed to reduce the risk of oxygen deficiency in your baby. Before planning a pregnancy, a woman needs to deal with the treatment of chronic diseases, get rid of bad habits. When pregnancy occurs, it is important to register with a medical institution at an early stage. Throughout the entire period of pregnancy, it is necessary to regularly visit a doctor, take tests and do an ultrasound scan. This will ensure control over the health of the pregnant woman and the baby, and, therefore, help to avoid the development of possible pathological conditions of the fetus.

An important aspect in the prevention of intrauterine hypoxia is maintaining a healthy lifestyle. It is necessary to spend a lot of time outdoors, sleep eight hours a day, balance the diet.

During pregnancy, you need to replenish the supply of vitamins and nutrients, the level of which decreases due to the additional load on the body. Levels of calcium, magnesium and other minerals should be maintained. It is especially important to control the iron content in the blood, since its low level leads to anemia - one of the main causes of hypoxia. Vitamin preparations should be taken as prescribed by your doctor.

Effects

The consequences of intrauterine hypoxia depend on its type. Chronic hypoxia, which began early in pregnancy, when the formation of the vital systems of the fetus is just beginning, can lead to the formation of congenital defects. Hypoxia, transferred in late pregnancy, can cause a delay in fetal development, and also leads to ischemia and necrosis of individual organs. A newborn baby often has a shortage of height and weight, as well as a difficult adaptation period (restructuring of the body in a new environment). In the future, oxygen starvation experienced in the womb can cause diseases such as epilepsy and cerebral palsy.

Acute intrauterine hypoxia of the child leads to ischemia and tissue necrosis. If acute hypoxia occurs during childbirth, several consequences are possible, depending on the cause of oxygen starvation:

  1. The baby's airways are not completely cleared of amniotic fluid. In this case, the development of pneumonia is possible, in the worst case, the death of a child from suffocation.
  2. Loss of large blood volume. A newborn develops hemorrhagic shock, which disrupts the mechanisms of work of all systems. Under such circumstances, there is a threat to the life of not only the baby, but also the mother.

After the birth of a baby who has undergone hypoxia in the womb, he needs constant monitoring of qualified specialists. The consequences of oxygen starvation may appear not in the first days of life, but much later. Therefore, it is very important to monitor changes and abnormalities in the development of the baby in order to identify and prevent the development of adverse effects of hypoxia.

Fetal hypoxia is a fairly common diagnosis in pregnant women. Fortunately, it is not always confirmed. But doctors are often reinsured, and women who are at risk of developing this pathology are taken under special control. To understand what the danger of lack of oxygen is and how to avoid it, we will analyze what are the causes of fetal hypoxia, what is its essence, what are the symptoms, treatment and prevention.

What is hypoxia

The life of an adult is built in such a way that we ourselves get our own nutrients from food, and oxygen from the air we breathe. We have a functioning digestive system, respiratory system, as well as various organs perform an excretory function, timely freeing the body from waste products. In a fetus in the womb, all internal organs and systems are in the stage of formation and growth, and the body is supplied with nutrients and oxygen through the bloodstream. The mother's blood, saturated with everything necessary, provides all the needs of a growing organism.

If this process is disturbed for some reason, fetal starvation begins, including oxygen starvation. It is this cessation or slowdown of the transfer of oxygen and nutrients to the child that is called hypoxia.

The development of hypoxia can be associated with a huge number of reasons and occurs both during pregnancy and during childbirth.

Causes and prevention of oxygen deficiency

A woman can hear the diagnosis "hypoxia" when she is about 28 weeks pregnant, and sometimes even earlier. The factors due to which fetal hypoxia can develop during pregnancy include the state of health of the mother and her lifestyle. The risk of pathology arises if the mother has untreated infections of the genitourinary system, as well as exacerbated chronic diseases of the cardiovascular system, kidneys or respiration. Hormonal disorders in a woman's body also affect the development of hypoxia.

All these risks can be mitigated by preparing for the birth of a child in advance. Before planning a pregnancy, it is necessary to undergo a comprehensive examination, treat infectious diseases and achieve a stable remission in relation to chronic diseases. It is also highly advisable to check the state of the hormonal background and check the condition of the thyroid gland. This is the initial prevention of fetal hypoxia and other equally severe pathologies.

If it was not possible to do this at the right time, it is important to consult a doctor as soon as possible and choose the methods suitable for pregnant women and the optimal treatment time. Most infections are treated after 12 weeks of pregnancy, when the formation of the main organs and systems of the fetus ends. After this period, the child is basically just growing, and the harm from medications will not be as global.

Hypoxia in newborns, as well as in those that have not yet been born, can develop due to an immunological conflict in the blood group and Rh factor. If the mother is a carrier of negative rhesus blood, and the child, for example, inherits a positive rhesus from the father, then a rhesus conflict may arise. This disorder rarely occurs in the first pregnancy. If a woman has already undergone childbirth or abortion, then antibodies could remain in her body, which will destroy the fetal immune system as foreign. This can be avoided by administering anti-rhesus immunoglobulin immediately after childbirth (or abortion). Thus, we do not protect the already born baby, but we make the next pregnancy safe.

Late toxicosis and the development of gestosis are factors that are very likely to cause fetal hypoxia. That is why in the second half of pregnancy it is so important to regularly visit a doctor and, if necessary, not refuse hospitalizations. Edema is a terrible symptom of gestosis, which is why doctors carefully monitor the weight gain in expectant mothers. With gestosis, blood flow is disturbed not only in the mother's body, but also in the mother-child system. Nutrients, and most importantly oxygen, are not delivered to the child in the required volume. It is known that nerve cells are the first to suffer from a lack of oxygen. Cerebral hypoxia begins to develop in newborns.

Doctors say that the physiological cause of hypoxia is the defective work of the placenta. Early aging of the placenta can be associated not only with medical factors, but also with the lifestyle of a pregnant woman.

The risk of hypoxia is primarily caused by physical and mental overload during pregnancy, insufficient quantity and quality of sleep and rest. Increases the risk of smoking and drinking alcoholic beverages.

But a sedentary lifestyle and over-eating are just as dangerous as overloading. If a woman moves too little, and being outdoors is reduced to sitting on a park bench, blood flow is slowed down. Only active physical activity can saturate the blood with oxygen, which is so necessary for a child.

Diagnostics, symptoms and treatment of hypoxia

For the diagnosis of hypoxia, methods such as CTG, ultrasound and dopplerometry are used. The CTG procedure is a study showing the dependence of the fetal heart rate on its motor activity. Ultrasound gives an idea of ​​the condition and location of the fetus, and also shows the degree of maturity of the placenta and its performance. Doppler will help to assess the quality and strength of blood flow that provides the baby with oxygen.

But a woman herself can and should monitor the condition of her child, notice the early symptoms of fetal hypoxia. She can do this already from 20 weeks of pregnancy, or even earlier, when she begins to feel movements. If their number has sharply decreased, less than 10 per day, there is every reason to consult a doctor and do an unscheduled ultrasound of the uterus.

In addition, the doctor himself monitors the child's condition. At each appointment, he listens to the baby's heartbeat using a special tube - an obstetric stethoscope. It also measures the length of the uterus and the volume of the abdomen with a measuring tape. If their growth is insufficient, an ultrasound scan is also prescribed in order to make sure of the presence or absence of intrauterine fetal growth retardation.

When fetal hypoxia is detected, treatment is carried out immediately. If there is no acute oxygen deficiency, the doctor tries to find out the cause of the pathology. For example, if the problem is in the failure of the placenta, drugs that thin the blood, as well as drugs that relieve tension of the uterus, may be prescribed.

The doctor decides how to treat fetal hypoxia. Each case is different. However, it is often impossible to find out or eliminate the cause of the lack of oxygen, and then all that remains is to carefully monitor the fetal movements of the woman, and doctors periodically perform studies of the blood flow in the umbilical cord and the heart rate in the child. In case of acute oxygen deficiency, a woman is urgently delivered by surgery.