Before birth, the baby does not breathe lungs, but receives oxygen through the umbilical cord. Intrauterine hypoxia of the fetus is caused by a mismatch between the growing baby's need for oxygen and its actual intake. This condition can cause various factors from both the mother and the fetus.
- reasons
- Signs
- during pregnancy
- Childbirth
- Forms and symptoms
- Lightning
- Acute
- Subacute
- Chronic
- Consequences
- Prevention
- Pharmacotherapy
- Kurantil
- Aktovegin
- Nospanum
- Magnesia
- ginipral
- Physiotherapy
- procedure Oxygen
- Therapeutic massage
- Glucose-containing injections
Causes of
Oxygen deficiency can be a consequence of pathology of the motherand, fetus, umbilical cord or placenta.
Pathologies on the part of the mother leading to hypoxia of the fetus are:
- Diseases of the hematopoiesis system( anemia of various origins);
- Pathologies of the cardiovascular system( congenital and acquired cardiac malformations);
- Diseases of the respiratory system( chronic bronchitis, bronchial asthma, pneumonia);
- Endocrine diseases( diabetes mellitus);
- Various kinds of intoxication.
Umbilical cord disorders:
- cord circumscription around the neck, arms or legs of the child;
- the nodes of the umbilical cord;
- clamping of the cord;
- abnormalities of umbilical cord length( short or long umbilical cord).
Causes of uteroplacental blood supply:
- premature detachment of the normally located placenta;
- placenta previa;
- dystrophic changes in the blood vessels of the placenta( gestosis, borne pregnancy).
Diseases of the fetus:
- genetic diseases and malformations;
- intrauterine head injury;
- hemolytic disease of newborns;
- intrauterine infection.
Hypoxia due to impaired labor:
- swift delivery;
- prolonged delivery;
- is the discoordination of labor.
Partitioning is very conditional. One reason may be a consequence of another.
Symptoms of
The manifestation of hypoxia varies depending on the phase of fetal development, the intensity of oxygen deficiency and its duration. Threatening hypoxia is characterized by the presence of causes that can cause it, but there are no obvious signs yet. On the onset of hypoxia, they say, when they discover one of its obvious or indirect signs.
to table of contents ^In pregnancy,
In early terms, fetal hypoxia causes a delay in its development. This is manifested by the discrepancy between the gestational age and the size of the fetus. In later periods, the signs of oxygen deficiency can be initially too frequent, and then too rare fetal movement. Reduction of fetal movements to 3 within an hour is a dangerous sign. When it is detected, it is worthwhile to see a doctor. With oxygen deficiency, the fetal heart rate decreases, reaching a level of less than 120 beats per minute, heart sounds are muffled.
According to the ultrasound Doppler scan, it is possible to determine the slowing of the blood flow velocity in the umbilical cord, the middle cerebral artery and the large arteries of the fetus. At a period of 28-29 weeks, cardiotocography can be used to determine the change in the fetal heart rate with its own stirring. Normally, when moving, the rhythm increases by 10-12 beats per minute. In the prenatal period, the monitoring of the baby's heart beats is automatically performed with the help of cardiac monitors. If necessary, apply electro- and phonocardiography, amniascopy and study of the acid-alkaline state of fetal blood.
At delivery of
During labor the fetal hypoxia is determined by the frequency of the baby's heart rate. Reducing it indicates a lack of oxygen. Also, indirect information on the presence of hypoxia gives an estimate of amniotic fluid. The presence of meconium in them also speaks of hypoxia. The Apgar scoring helps determine how the lack of oxygen affects the condition of the newborn. Heart rate, muscle tone, respiratory activity, skin color, reflex activity are evaluated. Each parameter is evaluated on a three-point scale from 0 to 2 points. At 5 -6 points, they talk about the depression of the newborn, at 4-1 points - about severe asphyxia.
Forms and symptoms
Clinical manifestations of hypoxia will depend on the volume of oxygen deficiency. The more shortage, the faster the disease develops. According to the rate of development of clinical manifestations, fetal intrauterine hypoxia is divided into 4 forms: fulminant, acute, subacute and chronic.
to contents ^Lightning-fast
This form is caused by a sharp lack of oxygen in the fetus in large quantities. The cause of the occurrence is a sharp exacerbation of chronic diseases, which bring the already existing hypoxia to a new level. It develops within a few minutes.
to the table of contents ^Acute
The speed of development is inferior to the lightning-fast form. Occurs most often during childbirth in the interval from a few minutes to 2 hours.
to contents ^Subacute
Occupies an intermediate position between acute and chronic forms. It occurs within 1-2 days before delivery.
to contents ^Chronic
This type of oxygen deficiency of the fetus develops gradually. The child's organism has time to adjust to unfavorable conditions. However, such a restructuring leads to deviations in development.
to contents ^Consequences of
Oxygen deficiency in the first trimester of pregnancy can lead to impaired organ development. Time taken measures to eliminate hypoxia can save a child. When a lack of oxygen occurs at later times, organs are affected. The most sensitive is the brain. Damage to it can be manifested by a lag in development, poor adaptation in the postpartum period, anxiety, seizures. Acute hypoxia during childbirth can cause bowel necrosis, aspiration pneumonia, development of cerebral palsy. The worst outcome of hypoxia is the death of the child in utero or during childbirth.
to contents ^Prevention
Preventive measures include:
- Pregnancy planning and preparation for it( early treatment of chronic diseases).
- Medical supervision of pregnant women.
- Regular examination with an obstetrician-gynecologist( monthly in the first trimester, twice a month in the second trimester and once a week in the third trimester).
- Mandatory visit to the women's consultation( before the first trimester).
- Balanced, rich in vitamins, microelements nutrition( for normal growth the child must have all the necessary components).
- Refusal to drink alcohol, smoking, harmful food.
- Regular exercise, without extreme stress. It is desirable that the complex of exercises included breathing exercises, swimming, yoga.
- Choosing the optimal type of delivery, to minimize the risk of fetal hypoxia.
- Regular delivery of tests, going to a women's consultation may seem burdensome. This is a compulsory measure that allows to determine the signs of the development of the disease at an early stage and to provide assistance in time. Be sure to follow the recommendations of your doctor.
Medication treatment
To improve blood circulation between the placenta and the uterus, vasodilators, tocolytics, and esterogenes are used. They can not be used for prophylaxis. Each drug is prescribed only in those situations when its use is justified.
The second group of drugs are drugs that increase resistance to hypoxia - antioxidants.
To reduce the effects of hypoxia, drugs that accelerate metabolic processes in the fetus, as well as drugs to maintain homeostasis.
to contents ^Kurantil
The active ingredient is dipyridamole. The substance has the ability to dilate blood vessels, improve venous outflow, improve blood flow, reduce the ability to glue together in platelets. The drug provokes the production of interferon, due to which increases the immunity. The drug is available in the form of tablets of 25 and 75 mg. It is allowed for use in pregnant women under the supervision of a doctor.
to table of contents ^Actovegin
Produced from calves' blood. Has antioxidant effect. Increases the tolerability of hypoxia by the fetus. The drug has no contraindications for prescription during pregnancy. Significant disadvantages of the drug include a high price and lack of a serious evidence base for its effectiveness. It is used according to the doctor's prescription. Produced in the form of tablets, injections and creams.
to table of contents ^No-spindle
The active ingredient is droteverin. Relieves spasm of smooth muscles. It is used to reduce the tone of the uterus. The appointment during pregnancy is allowed under the supervision of a doctor. Produced in the form of tablets, suppositories and injections.
to contents ^Magnesia
The active substance is magnesium sulfate. The effect of the drug depends on the route of administration. When ingestion causes choleretic effect, multiple liquid stool. With intravenous administration it has an antispasmodic effect, relieves swelling and vasospasm, relaxes smooth muscles, lowers arterial pressure. There are no contraindications to use during pregnancy. Use of medicines under the supervision of a doctor.
to table of contents ^Ginipral
The active ingredient is hexoprenaline. Tocolytic drug, which is prescribed for the threat of premature birth. Relaxes the musculature of the uterus, reduces the number and strength of premature labor. Contraindicated for use in the first trimester of pregnancy. It is used under the supervision of a doctor. Produced in tablets.
to the table of contents ^Physiotherapeutic procedures
Physiotherapy procedures are based on the application of methods of physical influence( light, heat, currents, magnets, sound waves) for the treatment of various diseases.
to table of contents ^Oxygenotherapy
Treatment by this method is based on the use of oxygen. In contrast to the usual inhalation, the method of enteric oxygenation is used - oxygen cocktails. Foam on the basis of oxygen after absorption is absorbed through the intestine increasing the oxygen content in the blood. The method is convenient because its use does not require expensive equipment.
to the table of contents ^Massage Therapy
Relatively safe areas are the neck, shoulders, arms, legs and back. Massage of these areas will relieve tension and improve blood circulation. Massage should be done only by a specialist.
to contents ^Glucose-containing injections
Glucose for intravenous injections is administered if there are signs of delayed fetal development. One of the reasons for this delay may be hypoxia. Directly on the cause of hypoxia, glucose is not affected, but it helps to gain weight to the baby before delivery.