Consequences of oxygen starvation of the child in the womb. Oxygen starvation of the fetus. Treatment of intrauterine fetal hypoxia

We all know that during pregnancy, a woman's thoughts rush in one direction. She dreams of a future baby, of a happy 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 take place safely, all processes in both organisms - children's and maternal - must proceed normally, as expected. Any violation can affect the condition of the baby. And this situation can arise for many reasons. Often, pregnant women are diagnosed with fetal hypoxia. And this is a serious reason to think and act.

What's happening?

The word "hypoxia" means lack of oxygen. That is, when it comes to fetal hypoxia, this means that the baby does not receive enough oxygen from maternal organism, and oxygen starvation of the fetus occurs, as doctors say. This condition can develop during pregnancy (and then chronic hypoxia is diagnosed) 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 it's not right away. First, a number of disorders go through in his small body, the consequences of which, if hypoxia is not detected and therapeutic measures are not taken in time, can be irreversible.

Lack of oxygen for early dates 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 mutilations. And on later dates the child’s central nervous system and physical development suffer: growth retardation occurs, the newborn adapts worse to the new environment, and may have physical and mental abnormalities. In children born with hypoxia, there are disorders of the autonomic nervous system, muscle hypertonicity, the baby is restless, naughty, eats and sleeps poorly. Such a child should be under the constant supervision of a neurologist.

When the fetus is experiencing a lack of oxygen, all its organs and systems begin to work in an enhanced mode, trying to get themselves a vital gas. This is possible due to the increased compensatory capabilities of a small organism. A woman feels such activation by the increased mobility of the baby. But this may not last long. And if the normal supply of oxygen is not restored and the metabolism is not normalized in time, depression soon sets in - the baby calms down, because without oxygen it can no longer move. The consequences of such a state may be irreversible. Therefore, if, after a sudden increase in 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 through additional studies: cardiotocography and dopplerometry.

Why does it happen?

Oxygen comes to all our organs and systems along with the blood. Transports oxygen, and without iron, it is not produced. That is, with (iron deficiency), the production of hemoglobin and, accordingly, the supply of oxygen to the blood and further throughout the body naturally decreases. However, the lack of iron in the mother's blood is not the only cause of hypoxia.

During pregnancy, the volume of circulating blood in the mother's body increases significantly, because it feeds the fetus through the placenta. If the utero-placental exchange worsens, the embryo cannot receive the required amount of all nutrients, including oxygen, supplied to it with maternal blood. Metabolic disorders between mother and fetus occur when placental insufficiency. It also blocks the supply of oxygen to the fetus during pregnancy, since nicotine constricts blood vessels and blood circulation is disturbed. And it is also known that tobacco smoke penetrates the embryo through the placenta, and it finds itself in a smoke screen - how can you not suffocate here ... It does not have the best effect on blood vessels and.

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

cardiovascular diseases of a pregnant woman;
anemia;
lung diseases (respiratory tract);
deep;
preeclampsia;
overwearing;
polyhydramnios;
multiple pregnancy;
violations at;
threat ;
pathology of the placenta and umbilical cord;
anomalies of labor activity;
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 carry out 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 complex manner. However, if there is no positive dynamics and the condition of the fetus worsens, the issue of conducting caesarean section(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.

Most importantly, do not smoke or drink alcohol. If possible, breathe only clean air. That is, if you live in a very polluted area, move to a cleaner area for this time. As often as possible, ventilate the room in which you live and. Every day arrange in the fresh air, but at the same time do not forget about good rest.

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

Of course, even a healthy lifestyle and good nutrition cannot be a 100% guarantee that hypoxia will not develop during pregnancy. But it will greatly increase your chances of preventing it. In addition, regular examinations by a gynecologist and consultations with a doctor will help to identify something was wrong in time.

Acute fetal hypoxia

A few more words about the lack of oxygen experienced by the child directly in 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 of the placenta. All this leads to fetal asphyxia (suffocation).

If acute hypoxia develops, the attending physician monitors the condition of the fetus, in particular, conducts cardiac monitoring, monitoring cardiac activity. Turbid greenish waters can become a prerequisite for this: this means that meconium has got into them. Such a criterion can be taken into account only with the head presentation of the fetus. In addition, acute hypoxia can be judged by analyzes amniotic fluid and fetal blood tests (by pH).

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

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

Especially for- Elena Kichak

In the process of intrauterine development, the fetus is in dire need of nutrients and oxygen. Access to them is an important condition and guarantee of the health of the child. Lack of oxygen or, scientifically, hypoxia is a serious violation, dangerous possible complications and adverse consequences.

What is intrauterine fetal hypoxia

During intrauterine development, by the beginning of the 2nd trimester, the placenta is formed - the connection between the mother's body and the fetus. Thanks to the umbilical cord, blood enriched with oxygen and nutrients enters the baby's body. For intensively growing and multiplying cells, a sufficient amount of oxygen - important factor, which ensures the metabolism at the proper level.

Under normal conditions, nutrients and oxygen are sufficient to provide the body of the fetus with everything necessary. The adequacy of the work of the mother-placenta-fetus system is of great importance during the 2nd and 3rd trimesters, since at this time the development and maturation of the central nervous system occurs. But, with various disorders, hypoxia occurs - a state of acute or chronic lack of oxygen. Without the required amount of this gas in the blood of the fetus, a violation of biochemical processes occurs. Brain cells are most sensitive to this pathology. This explains mainly neurological disorders in children resulting from intrauterine fetal hypoxia.

Damage to the central nervous system can lead to the death of nerve cells, which, as you know, do not recover. As a result of such damage, gross defects occur, manifested as epilepsy, cerebral palsy, lag in mental development.

Less serious, but no less significant disorders are also associated with intrauterine hypoxia. Minimal brain dysfunction, hyperactive child syndrome, perinatal encephalopathy are pathologies directly related to a lack of oxygen.

Severe acute fetal hypoxia can lead to the death of the child.

Classification of intrauterine fetal hypoxia

For reasons, fetal hypoxia is divided into:

associated with the mother's body;
associated with pathologies of the placenta and umbilical cord;
associated with the fetus.

According to the body's ability to compensate for disorders that occur during hypoxia:

compensated hypoxia;
subcompensated hypoxia;
decompensated hypoxia.

By time:

chronic hypoxia - more often occurs during pregnancy;
acute hypoxia - often occurs due to obstetric pathology in childbirth.

Causes of intrauterine fetal hypoxia

Causes of fetal hypoxia associated with the mother's body

Carbon monoxide from smoke binds tightly to hemoglobin molecules, the protein that carries oxygen in the blood. From the outside, this can be imagined as an attempt to get into a crowded bus at rush hour. If normally each passenger is one molecule of oxygen, then in the blood of a smoking woman, figuratively speaking, the places are occupied by carbon monoxide. Everyone will reach the final stop, but not those who are needed. Only a portion of the required oxygen will reach the fetus.

Children of smoking mothers are often born with developmental anomalies. They lag behind in development, start talking and walking later, suffer from the effects of hypoxia and the toxic effects of tobacco smoke.

Maternal illnesses also affect the baby's oxygen supply. Cardiovascular pathologies, lung diseases, anemia can cause acute and chronic hypoxia. For example, inflammation of the lungs during pregnancy dramatically reduces the area of effective gas exchange. Absorbing less oxygen from the air, the mother's body is not able to deliver the required amount to the fetus.

Anemia - a lack of hemoglobin and oxygen-carrying red blood cells, is also a common cause of intrauterine hypoxia. However, the role of blood diseases in the development of hypoxia is very large.

Pregnancy against the background of chronic diseases is always the possibility of a number of complications, including fetal hypoxia.

Causes of fetal hypoxia associated with the placenta and umbilical cord

Feto-placental insufficiency - a violation of the normal function of the mother-placenta-fetus system, also leads to intrauterine hypoxia. The cause can be anything from anemia and infections to severe pregnancy complications.

From the placenta, blood enters the baby's body through the umbilical cord. The latter contains arteries and veins. Mechanical obstacles (torsion, kinks, compression, entanglement) reduce the permeability of blood through the umbilical cord and can lead to fetal hypoxia.

The most severe cause of fetal hypoxia is a serious complication of pregnancy called preeclampsia. At the heart of gestosis is a sharp increase in blood pressure due to vasospasm. Not only the blood supply to the fetus suffers, but also the vital organs of the mother's body. In developed countries, this pathology is the main cause of maternal and child mortality.

Causes of intrauterine hypoxia associated with the fetal body

Symptoms of fetal hypoxia

Signs of fetal hypoxia: at first, a lack of oxygen excites the motor center of the child's brain. Clinically, this is manifested by an increase in the strength and frequency of movements, tachycardia (rapid heartbeat) in the fetus. With the breakdown of compensatory mechanisms and the accumulation of carbon dioxide in the blood, oppression occurs motor activity and cardiac activity. External manifestations- absence or decrease in the frequency and strength of movements, slowing of the fetal heart rate (bradycardia). However, such symptoms are characteristic of acute hypoxia. In addition, the evaluation method is subjective. Studies have shown that the effectiveness of such diagnostics is very low. But, the absence of fetal movements for 12 hours is a reason to seek medical help.

Indirect signs of hypoxia at birth are cloudy green amniotic fluid due to the presence of meconium in them, cyanosis of the skin, and a low Apgar score.

Chronic hypoxia is difficult to recognize without instrumental methods. To diagnose intrauterine fetal hypoxia, cardiotocography (method of recording fetal heart rate and uterine tone) and ultrasound are used.

Diagnosis of fetal hypoxia: cardiotocography records fetal heart rate and uterine muscle contraction. Normally, a child's heart makes 120-160 beats per minute per minute. An unstable or low fetal heart rate indicates hypoxia. Currently, the method is used in automated devices. They are called antenatal heart monitors. The equipment allows you to monitor the condition of the child before and during childbirth without human intervention.

For planned studies, fetal ultrasound with vascular dopplerometry has become more widespread. The method allows you to determine the amount of blood flow in given vessels - the arteries and veins of the umbilical cord, the main vessels and the middle cerebral artery fetus. Slowing blood flow is a sign of hypoxia.

An indirect sign of fetal hypoxia on ultrasound is also considered a discrepancy between the weight and size of the fetus and the gestational age (intrauterine growth retardation).

Treatment of intrauterine fetal hypoxia

In chronic fetal hypoxia, treatment is aimed at improving the uterine placental blood flow. For this purpose, they correct violations of the blood coagulation system, treat anemia, and normalize the tone of blood vessels and uterus. Used drugs that improve metabolism. Vitamins and antioxidants prevent cell damage in the absence of oxygen.

Of great importance is physical activity, proper rest, elimination of stress and stress on the body. Recommended walks in the fresh air, gymnastics to prevent congestion in the pelvis. In severe cases, strict bed rest is prescribed. Nutrition is balanced, healthy, rich in vitamins and proteins.

Studies have shown that moderate chronic hypoxia is less dangerous. The child's body has time to adapt, to compensate for the lack of oxygen. Acute fetal hypoxia, which has arisen due to premature detachment of the placenta, entanglement, and other obstetric pathology, requires immediate operative delivery. The lack of oxygen can be alleviated with oxygen therapy.

The consequences of intrauterine fetal hypoxia

Chronic lack of oxygen contributes to intrauterine growth retardation. Statistical studies have shown an association between hypoxia and sudden infant death syndrome. This pathology does not manifest itself, has no symptoms. But, due to a violation of the function of the respiratory center, possible fatal disorders - in a dream, the child simply stops breathing. At an older age, mental retardation, attention deficit, hyperactive child syndrome are possible.

Complications of acute fetal hypoxia are more severe. This is the main reason for the transfer of a child after birth to the intensive care unit and resuscitation. Damage to the central nervous system, which consists in the death of neurons (brain cells), can lead to cerebral palsy, epilepsy, mental defects. In severe cases, childhood disability is possible. Such a child begins to walk at the age of 3-4, to speak even later. Unfortunately, this is not uncommon. The consequences of hypoxia are difficult to treat.

Prevention of fetal hypoxia

Such serious pathologies are easier to prevent than to treat. healthy image life, balanced nutrition, sports are useful for the body of the expectant mother. Timely treatment of chronic diseases before pregnancy dramatically reduces the incidence of obstetric complications.

Many women complain that during pregnancy they often have to undergo examinations and take tests. This is a forced measure - in recent decades normal pregnancy has become a rare occurrence. But, timely diagnosis and treatment is a guarantee that everything will be fine. It is necessary to strictly follow all the prescriptions and recommendations of the doctor.

The normal course of pregnancy can greatly complicate the diagnosis, which sounds threatening to the expectant mother - “fetal hypoxia”. According to statistics, every third pregnant woman faces such a problem to one degree or another. Why a child begins to suffer from a lack of oxygen and how dangerous it is for his health, we will tell in this article.

What it is?

Fetal hypoxia is a state of oxygen starvation in which the child suffers quite severely. Most expectant mothers have chronic hypoxia, in which the lack of oxygen in the baby lasts for quite a long time. Sometimes the condition is acute, and this is very dangerous for the fetus, as it can lead to the death of the child in utero from asphyxia.

With an insufficient level of oxygen, which the baby receives through the bloodstream for all 9 months, serious changes occur in his body - the metabolism changes, pathological changes in the nervous system of the crumbs are observed.

If the hypoxia is insignificant, the baby is quite capable of coping with this condition with little or no consequences for himself, since the compensatory mechanisms even in an unborn baby are incredibly large. So, the baby “stores” oxygen in advance, since the number of O2 molecules in his blood is much higher than in the blood of an adult, so when starvation sets in, he will be able to consume his own reserves for some time. In addition, the adrenal glands react quickly to the lack of oxygen in the baby, which immediately in response produce hormones that allow for a while to increase blood pressure and normalize the heart rate.

Despite all this, unfortunately, these mechanisms are not able to compensate for prolonged hypoxia or acute fetal hypoxia. When the gynecologist who observes future mother, indicates the presence of fetal hypoxia, he necessarily specifies what degree of the problem is in question. 1 degree - insignificant, the second and third may be the basis for hospitalization of a pregnant woman or premature delivery if the baby's condition is threatening.

The lack of oxygen during pregnancy is usually chronic.

Acute hypoxia most often develops during childbirth. It is provoked by incorrect actions of medical personnel - stimulation of contractions with strong medications, aggressive acceleration of the birth process.

Predict possible consequences for a child, doctors can already be in the delivery room, since the condition of the baby immediately after birth speaks volumes. Depending on him, he is given the first grades in his life - points on the Apgar scale, this assessment system necessarily includes an assessment of the post-hypoxic state. The lower the score, the more serious the problems may be in the future. A child born with acute hypoxia is characterized by low scores in the first 10 minutes after birth, but after an hour the child can safely be given 7-8 Apgar points. In this case, the forecasts are positive. If the baby's condition does not improve or begins to worsen, the prognosis is not so rosy.

Causes

Chronic hypoxia can occur for a number of reasons:

maternal diabetes;
viral infection in the first trimester of pregnancy;
pregnancy with twins or triplets;
prolonged state of threatened abortion, threatened miscarriage;
partial placental abruption, spotting;
post-term pregnancy (more than 40 weeks);
anemia pregnant;
violation of uteroplacental blood flow;
bad habits - smoking during pregnancy, alcohol, drugs.

Acute hypoxia occurs in cases of complications in childbirth with:

entwining the baby with the umbilical cord with clamping the umbilical cord ring;
polyhydramnios;
twin or triplet pregnancies;
premature detachment of the placenta, which often occurs with rapid, rapid labor or in labor that is stimulated by piercing the fetal bladder or medication;
primary or secondary weakness of ancestral forces.

Diagnostics

Diagnosis of fetal hypoxia is not an easy task, because babies behave differently in the womb. One is lazy due to temperament and rarely moves, the other is active, and his frequent movements are often taken by both women and doctors as a manifestation of hypoxia. Some symptoms should alert:

a change in the nature of the motor activity of the fetus, in which at first the baby moves chaotically and often with strong painful shocks, and then, as oxygen starvation develops, the movements become more and more rare;
the height of the bottom of the uterus is significantly lower than normal;
the child develops with a noticeable lag (fetometric indicators are below the lower limit of the norm);
a pregnant woman is diagnosed with oligohydramnios.

In late pregnancy, doctors advise to monitor the baby's movements especially carefully, the number of movements should be recorded in a diary.

Normally, an awake baby should make up to 10 movements per hour. These can be coups, easily perceptible and distinguishable, and barely noticeable movements. It is recommended to register movements from 20-22 weeks of pregnancy until its completion.

If the doctor, on the basis of the deviations from the norms described above, suspects hypoxia, he will definitely prescribe a CTG to the pregnant woman. During cardiotocography, sensors attached to the abdomen will record all the movements of the baby, a change in his heart rate, even hiccups will be reflected. Additional research methods include doplerometry, fetal ECG, and ultrasound (this differs from the standard ultrasound procedure in that the doctor will not look at parts of the child’s body, but at the blood flow velocity in the uterine arteries, in the umbilical cord). An extended blood test from the mother's vein, in addition to the methods listed, allows you to determine whether there is enough hemoglobin in the blood and clarify other biochemical factors.

Acute birth hypoxia does not need extended diagnostics, since the real-time fetal monitor immediately registers the pathological state of oxygen starvation in the child as soon as it occurs.

The most reliable sign is bradycardia - a decrease in heart rate in a baby who has not yet had time to be born. If the normal fetal heart rate is from 120 to 170 beats per minute, then in a baby who suffers oxygen starvation, the heart rate will be at the level of 80-90 beats per minute. Tachycardia can also be said about the lack of oxygen if the child's heart rate is above 180-190 beats per minute.

Amniotic fluid in which there was a child with chronic hypoxia is sometimes dark or dark green in color, with bad smell meconium (original feces of a newborn). The baby himself after birth will be weaker than other babies, he will have reduced or increased muscle tone, neurological disorders of varying severity.

Possible consequences

The most formidable, but, alas, absolutely real consequence of oxygen starvation is cerebral hypoxia. It is the brain that suffers from hypoxia more often and more strongly than other organs. Even the most experienced doctor will not undertake to predict what disorders will cause dysfunction of one or another part of the brain in the perinatal period. However, after childbirth, it is quite possible to assess the traumatic impact. And if some violations, such as problems with speech development become apparent later, then gross hypoxic-ischemic lesions of the central nervous system in most cases can be diagnosed even in maternity hospital, in extreme cases - in the very first months of a baby's life.

The consequences for the nervous system due to brain cells dying during oxygen deficiency can be different - from moderate hyperactivity of the child in the future to severe lesions, which include cerebral palsy, paresis of various dislocations. In complicated childbirth in a state of acute hypoxia, cerebral hemorrhage, ischemia, and cerebral edema often occur. The damage that occurs with such violations can be total and irreversible.

Both acute and chronic oxygen deficiency can lead to a wide variety of diseases, mainly of a neurological nature. So, problems with vision or hearing are a fairly common posthypoxic consequence. If hypoxia was prolonged, then the child may have underdevelopment or abnormal development of some internal organs, heart disease, kidney disease and so on. Minor neurological disorders in most cases, the child manages to "outgrow" by the age of 6-7, of course, with constant monitoring by a neurologist and the implementation of all his recommendations.

In general, the prognosis with regard to possible consequences directly depends on how early hypoxia was detected and how quickly treatment was provided. That is why women are not recommended to skip the next consultation appointment, and ladies with chronic diseases you have to visit the obstetrician two to three times more often.

Treatment during pregnancy

The established fact of hypoxia during pregnancy should in no case be ignored; fast and effective therapy is needed to minimize the possible consequences for the baby. Doctors urge expectant mothers, first of all, to calm down, since excessive nervous experiences only aggravate the already rather difficult condition of the child.

In the later stages, severe hypoxia may be an indication for urgent delivery by caesarean section. At earlier dates, when the baby is still very early to be born, doctors will try to do everything possible to make the baby feel better. Treatment can be done at home, but on condition that the severity of hypoxia does not exceed 1 degree. The remaining cases are subject to urgent hospitalization and constant monitoring of the pregnant woman and the baby in the hospital.

Doctors prescribe bed rest for mothers, it is with it that the blood supply to the placenta increases and minor hypoxia can be cured as soon as possible. The main approach to drug therapy is the use of drugs that improve uteroplacental blood flow, such as Curantil, Actovegin. In severe hypoxia, these drugs are administered intravenously by drip. In other situations, it is allowed to take pills. A woman is prescribed vitamins, iron, magnesium preparations. Treatment courses are repeated.

If a woman has an underlying disease, which, presumably, caused oxygen deficiency, then treatment should include therapy for this disease.

Two specialists take part in this - an obstetrician-gynecologist, who knows what is possible and what is impossible for his patient in an “interesting” position, and a specialist doctor who is in charge of the disease. They should prescribe medications and manipulations together, the treatment, as it was before pregnancy, usually changes.

A child who has experienced acute birth hypoxia, in the very first hours after birth, will receive powerful vascular therapy, he will also be given sedatives, vitamins, especially group B. A neurologist will observe the baby from the first hours of his independent life.

Treatment after birth

Without exception, all children who experienced hypoxia during their intrauterine existence are shown special observation in pediatric neurologist. Almost always, such babies, regardless of the consequences, are put on dispensary records. In the vast majority of cases, they are recommended massotherapy from the very first days, taking vitamins, water procedures with the use of soothing decoctions of medicinal herbs. Many babies after 3-4 years of age require speech therapy to overcome probable problems with speech development and pronunciation.

The rest of the treatment depends only on what posthypoxic diagnosis was established, because with cerebral palsy one approach and choice is required. medications, and with a pathological decrease in hearing or vision - completely different. Cerebral palsy is considered to be the most difficult in treatment, and increased cerebral palsy is most easily corrected. muscle tone without other neurological symptoms. Parents should prepare for a rather lengthy treatment, since post-hypoxic consequences that are subject to correction take years to eliminate.

You can find out some more information about fetal hypoxia in the next video.

In this article:

What is fetal hypoxia?

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

Pathology can occur both in early pregnancy and later. Regardless of the time of manifestation of such a condition, the consequences of oxygen deficiency are always unfavorable for the unborn child. Intrauterine hypoxia of the fetus that occurred in the early stages can lead to developmental abnormalities.

The manifestation of hypoxia at a later date 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 a slight, short-term hypoxia, most likely, will not adversely affect the health of the unborn baby. But prolonged or severe oxygen starvation can lead to irreversible consequences.

In order to prevent the development of pathology, one should know about the causes of hypoxia, the signs of a violation, and methods for preventing such a condition.

Causes 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, these are various diseases of the future mother (for example, disorders of the cardiovascular system, intoxication, anemia, etc.), as well as disruptions in the normal functioning of the placental blood flow, for example, due to preeclampsia, overmaturity, pathologies of the umbilical cord and placenta. Fetal diseases, for example, such as anemia, malformations, can also cause hypoxia.

Much is known about the mechanisms of the development of pathology: hypoxia is caused by disturbances in the supply of oxygen to the uterus and metabolic processes of the placenta, hemoglobin deficiency, and manifestations of cardiovascular insufficiency.

Some doctors, talking about 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.

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

Among these diseases are:

intoxication of the body due to poisoning, toxicosis, harmful working conditions or functional disorders in the kidneys;
diseases or pathology of the development of the lungs;
heart failure;
anemia
diabetes.

Also to pathological condition some complications during pregnancy can lead to:

(increased amount of amniotic fluid);
toxicosis in the last months of pregnancy -;
malfunctions of the placenta or uteroplacental blood flow.

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

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

signs

It is important not to miss the first signs of intrauterine fetal hypoxia. Indeed, in most cases, timely measures can avoid negative consequences, which will invariably manifest itself during prolonged oxygen starvation.

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

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

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

At the disposal of modern medicine there are many research methods that, with varying accuracy, allow us to confirm or refute the presence of oxygen deficiency, to determine the degree of danger to the fetus. Among the methods used, the most accurate and informative CTG (cardiotachography), phonocardiography, dopplerometry, amniotic fluid examination (amnioscopy) can be distinguished.

The possibilities of ultrasound scanning are also widely used, thanks to which it is possible to identify uneven respiratory movements made 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 the troubles of a child who is born. One of the signs of acute oxygen starvation is green waters stained with meconium.

Consequences for the child

The consequences of fetal hypoxia that occurred 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 the improvement of an unfavorable state will come by itself! The longer and more intense the oxygen starvation, the stronger the changes occurring 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 balance of electrolytes in the body of an unborn child is disturbed, 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 cause fetal death or serious asphyxia of the newborn.

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

Prevention

Prevention of fetal hypoxia consists in regular medical supervision of a woman throughout pregnancy. Timely diagnosis and timely treatment are of great importance for the health of the child. Identification of complications of pregnancy, monitoring the condition of the fetus is the doctor's task. The future mother should lead a correct lifestyle, give up harmful or dangerous work, try to avoid unrest.

Prevention of fetal hypoxia during childbirth, first of all, depends on the competent actions of the doctor: 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 a special breathing technique in advance and apply the acquired skills in practice at the right time. Controlling her own breathing helps a woman get enough oxygen in labor, which has a positive effect on the condition of a child ready to be born.

Methods for the treatment of fetal hypoxia

In the treatment of chronic fetal hypoxia, the knowledge and experience of the doctor, as well as the correct attitude and discipline of the expectant mother, are important. One dose of prescribed medications is usually not enough. Often a woman has to reconsider her own lifestyle during pregnancy, making a choice in favor of a relaxing holiday. Sometimes for the health of the baby, you need to take bed rest, which helps improve the blood supply to the uterus.

Often, if hypoxia is suspected, the doctor decides to hospitalize 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, therapy is carried out 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).

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

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

In the event that complex therapy does not bring the desired effect and the condition of the fetus worsens, while the gestational age exceeds 28 weeks, the issue of emergency delivery by caesarean section is resolved.

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

conclusions

Hypoxia can be dangerous to 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 undesirable consequences in the event of a pathology.

If possible, a pregnant woman should avoid stressful situations. Strong unrest does not have the best effect on the health of the expectant mother and affects the development of the fetus.

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

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Hypoxia literally means lack of oxygen, this pathology of newborns is quite common, and its consequences after birth in a child are more than serious. Oxygen starvation can occur in utero (fetal hypoxia) or during childbirth, and there are a lot of reasons for this.

Intrauterine hypoxia (chronic)

Causes of intrauterine hypoxia:

Multiple pregnancy.
Risk of miscarriage.
Diabetes.
Bleeding in a woman.
Infectious diseases.
Serious illness in the 1st trimester.
Smoking.
Any kind of addiction.
Overgrowth of the fetus.

Unfortunately, by outward signs and the behavior of the child during pregnancy, diagnosing hypoxia is too difficult. Only a few indirect signs can indicate the presence of a problem:

Strengthening and acceleration of fetal movements, followed by weakening up to attenuation.
Child growth retardation.
The fundus of the uterus is below normal.
Low water.

If there is any doubt, it is better to conduct additional studies (CTG - cardiotocography, NST - non-stress test, BFP - determination of the biophysical profile of the fetus, electrocardiogram (ECG) of the fetus, doplerometry, advanced blood tests ...). It may be necessary to prescribe maternal therapy that improves the blood supply to the fetus.

Birth hypoxia (acute)

Hypoxia can also occur during childbirth, then it is called intranatal. This type (acute hypoxia) most often no longer depends on the mother, but is the result of belated or unskilled obstetric care. Therefore, every woman in labor, going to the maternity hospital, should imagine what qualified obstetric care should look like during childbirth and normal birth process, not to allow experiments to be carried out on oneself or to put up with frankly wrong medical care.

In the early 1960s, aggressive obstetrics began to be widely practiced in the Soviet Union, even during normal childbirth, with the use of labor-stimulating agents. These methods include: drug stimulation of contractions and piercing of the amniotic sac. Such assistance poses a serious threat to the health of both the newborn and the mother. Rapid childbirth is not natural, because the organisms of the child and the woman in labor must adapt, while harsh intervention during childbirth is fraught with birth injuries and acute fetal hypoxia is often the result of unjustified actions of the medical staff.

How to care for your baby immediately after birth and throughout the first year of life

The main causes of hypoxia during childbirth

Detachment of the placenta ahead of time.
Weak birth.
Umbilical cord wrap.
Polyhydramnios.
Multiple pregnancy.

It is possible to predict the consequences of hypoxia immediately during childbirth.

Depending on the degree of oxygen starvation before and during childbirth, the consequences for the baby may be different. Conditionally, the prognosis can be determined according to the assessment of the condition of the newborn child on 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 may be of moderate severity. If Apgar scores are lower, then we can expect severe consequences. And this means that there will be neurological disorders, the child may be hyperactive, with a mental lag or physical development, with various mental and speech pathologies.

Most of all, the brain suffers from a lack of oxygen, and it coordinates the work of all body systems, so the consequences of severe hypoxia (chronic or acute) can be very different and make themselves felt in the most unexpected manifestations. How serious everything is can be judged by the fact that the brain is completely switched off 15 seconds after the cessation of oxygen supply with the blood, and neurons begin to massively die as early as five minutes after circulatory or respiratory arrest.

Infringement of the umbilical cord and the lack of spontaneous breathing during childbirth is the cessation of blood flow to the child's body, blood pressure decreases, and venous blood pressure rises. As a result, there are such serious damage to the brain of the newborn as ischemia, edema, hemorrhage, and the consequences of such damage can be irreversible. The most serious consequences of oxygen starvation include cerebral palsy. The mass appearance of children with such a diagnosis is associated with the widespread use of labor-stimulating agents.

The surest sign of hypoxia in an unborn child is a decrease or increase in the heart rate during childbirth and changes in fetal activity. A sure sign of hypoxia is bradycardia (slow heartbeat) up to 90 beats / min in the case of head presentation and less often 80 beats / min in the case of pelvic presentation, or tachycardia (palpitations) more often than 190 beats / minute.

How a hematometra can ruin life after childbirth

In the case of diagnosing hypoxia in a child after birth, a neuropathologist should deal with him from the first hours of life.

Already in the hospital, depending on the severity of hypoxia, the fight against its consequences should begin - drugs can be prescribed that improve brain function, sedatives, special massages and physical education, physiotherapy.

Parents need to prepare for the fact that they are likely to need help in the future child psychologist and a speech therapist.

From the foregoing, it is clear that from the very beginning of pregnancy, one must not only carefully monitor one's health, but also take full responsibility for the choice of the observing and attending physician, and especially carefully choose the place where the birth will take place.

Just don't panic!

In such an important and responsible period as pregnancy, taking care of your own health and the future of the baby is also about maintaining a harmonious psychological state pregnant. The risk of stress should be minimized. One of the most important tasks is to prevent the appearance of various phobias, primarily related to the condition and development of the child.

As for hypoxia, it must be remembered that even serious somatic diseases of the mother do not necessarily cause intrauterine fetal hypoxia. Nature made sure that the baby was protected as much as possible. There are many special physiological mechanisms that prevent the occurrence of hypoxia and compensate for deficiencies in the blood supply from the mother.

In particular, the blood of the fetus "holds" much more oxygen molecules than the blood of adults. The fetal heart pumps much more blood per unit of time than the heart of adults. At the same time, hemoglobin is seriously different in its structure; hemoglobin molecules in the fetus attach and remove oxygen much faster. The entire cardiovascular system of the fetus has a special structure designed to prevent oxygen starvation.

Some compensatory mechanisms and functions of a global scale are also provided. In particular, as soon as a signal is received about the beginning of hypoxia, the adrenal glands are reflexively activated, the release of hormones increases, contributing to an increase in heart rate and an increase in blood pressure. The blood flow is redistributed, visibly activating in the brain, heart, placenta and adrenal glands and decreasing in the skin, lungs, intestines, spleen. That is, more important organs receive large volumes of blood, and slight hypoxia practically does not affect the intrauterine development of the baby.

In case of serious problems, the baby's intestines are so poorly supplied with blood that the anus (anus) completely relaxes and meconium (the original feces of the fetus) enters the amniotic fluid. If during childbirth a change in the color of amniotic fluid is detected (normal ones are transparent), then this is evidence of chronic intrauterine hypoxia.