What is chronic intrauterine fetal hypoxia. Intrauterine fetal hypoxia: symptoms and diagnosis. Consequences in the future

Intrauterine fetal hypoxia is a deficiency of oxygen necessary for the embryo for the proper formation and development of organs and tissues. This pathology can lead to serious consequences for the health and life of both the baby and the mother, and therefore it is important to diagnose and start treatment in a timely manner.

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Types of intrauterine hypoxia

The classification of the disease is carried out according to two factors - the duration of hypoxia and the stage of severity of the main symptoms.

First group:

Chronic fetal hypoxia is a prolonged deficiency of oxygen supply to the tissues of the embryo due to maternal diseases or placental disorders.
Acute hypoxia is a sharp and pronounced lack of oxygen. This type of disease can develop with placental abruption, birth asphyxia of the baby and other pathological situations.

Classification of hypoxia in accordance with the clinical picture of the manifestation of the disease:

Threatening - symptoms of oxygen deficiency are not observed, but conditions develop that are provoking factors (pregnancy prolongation, premature aging of the placenta, etc.). Prevention of hypoxia is necessary.
Started - clearly expressed clinical picture oxygen starvation, which requires immediate treatment.

Degrees of chronic hypoxia

Intrauterine hypoxia in the embryo most often develops in the second and third trimester, when the fetal oxygen demand increases sharply. Under the influence of a damaging factor, adaptive mechanisms are triggered for a certain time. They protect the organs and tissues of the fetus without stopping the normal development process. With prolonged hypoxia, the protective ability decreases and the disease begins to progress.

There are the following degrees of chronic lack of oxygen in the fetus:

Compensated. Develops at first oxygen deficiency. During this period, the work of the adrenal cortex, which affects the amount of hormones, increases. Thus, the heart rate, vascular tone, blood volume, as well as red blood cells and hemoglobin increase. All these changes contribute to faster movement and saturation of cells with oxygen. At this stage, the main symptom is more intense fetal movements. At the first stage, the uterus and placenta are able to cope with the negative effects of oxygen deficiency and ensure the normal development of the embryo. With the timely recovery of the mother's condition, the pregnancy proceeds normally.
Partially compensated. The protective functions of the fetus restructure the work of the body to provide oxygen to vital organs (heart, brain and spinal cord). As a result, the remaining tissues are exposed to insufficient blood supply, ischemia occurs. For example, such a process in the intestine leads to the opening of the anus and the release of meconium into the amniotic fluid. At this stage, the protective capabilities of the uterus and placenta are almost exhausted. Urgent treatment is needed, since the risk of disruption in the formation of many organs of the embryo is significantly high.
Decompensated. There is a breakdown in the work of the body. The adrenal cortex can no longer produce cortisol even in a minimal amount. The heart rate decreases, the fetus becomes inactive, movements practically disappear. Ongoing oxygen starvation leads to minor hemorrhages in the brain and other organs, blood clots can form. Due to the accumulation of carbon dioxide in the blood, the baby tries to breathe through the glottis, which leads to mucus, water and meconium entering the lungs. This is a direct path to asphyxia during childbirth when trying the first breath.

Scheme of fetal hypoxia

Causes

The developmental mechanisms and factors that lead to oxygen deficiency can be quite diverse and are grouped into several categories.

Diseases and conditions of the mother

The first group of factors refers to the diseases and lifestyle of a pregnant woman:

low hemoglobin;
systemic diseases (for example, diabetes mellitus);
severe blood loss;
diseases of the heart, kidneys, lungs and bronchi, infectious lesions;
smoking, staying in rooms with polluted air;
toxic damage to the body;
low birth weight, narrow pelvis;
sedentary lifestyle.

Violation of the uteroplacental blood flow

delayed pregnancy;
high risk of rapid delivery;
a variety of complications and pathologies during pregnancy (preeclampsia and others);
structural and functional disorders placenta and umbilical cord;
placenta previa or its incorrect attachment in the uterus;
twisting or prolapse of the umbilical cord;
complications during childbirth.

Features of the course and complications of this pregnancy

Intrauterine fetal hypoxia can cause the following problems during pregnancy:

Threat of interruption. It occurs both as a result of stress and severe overwork of a woman, and in connection with various diseases mother and disorders in the development of blood flow between the uterus and the placenta.
Increased tone of the uterus. There are prolonged and frequent contractions of muscle tissue long before the date of birth of the baby. As a result, the flow is interrupted arterial blood to the embryo.
Multiple pregnancy. It is more difficult for the uterus and placenta to provide oxygen to several embryos.

Diseases and conditions of the fetus

Causes of hypoxia:

infections;
malformations of organs and systems;
intracranial hematoma;
incompatibility of the blood of the embryo and mother;
pelvic presentation.

Signs of hypoxia

In the first months of pregnancy, it is possible to determine the oxygen deficiency for the fetus only by instrumental diagnostic methods. Indications for such studies may be maternal illness, as well as the presence of factors from the list above. Therefore, it is so important to visit the doctor on time and talk about all the atypical and typical symptoms of pregnancy that concern you. Perhaps it is one of them that will lead the doctor to the idea that there is a risk of pathology and fetal hypoxia.

For more later dates mothers need to carefully monitor the movements of the baby. Some doctors believe that hiccups and increased movement may also indicate hypoxia. But the cause of such symptoms may be wrong position fetus in uterus or maternal stress. If similar signs quickly pass, then there is no reason to worry.

Reducing the number of waves of movements during the day is the main alarming figure, with the appearance of which you need to immediately consult a doctor for a more thorough diagnosis.

Diagnostics

It is possible to identify the onset of hypoxia during a routine examination of a pregnant woman - poor tests (low hemoglobin is the first symptom of oxygen deficiency in the mother's blood) or a woman's complaints about a decrease in fetal activity. After that, a more thorough examination takes place in order to recognize the presence of oxygen starvation in the embryo.

The first step is to interview the expectant mother:

woman's age;
medical history;
current state, the presence of non-standard symptoms;
previous pregnancies - course and outcome;
bad habits, lifestyle;
working conditions.

Cardiotocography

The method allows you to calculate the heart rate of the fetus, as well as monitor its activity, record the influence of the mother's movements on the baby.

The principle of operation of the CTG apparatus

Research results for a healthy fetus:

contractions of the heart from 120 to 160 beats per minute;
the heartbeat increases with the activity of the embryo or a sharp movement of the pregnant woman;
no slowdown in heart rate.

With fetal hypoxia, the results of cardiotocography will have the following features:

very slow or, conversely, accelerated heartbeat;
reduced motor activity of the embryo;
there is a frequent decrease in heart rate.

Doppler

One of the types of ultrasound diagnostics, in which the vessels and the state of blood flow in the uterus, placenta and umbilical cord are evaluated. The result of the study is a Dopplerogram, built on the basis of an analysis of the frequency difference between the sent and reflected signals from moving blood erythrocytes. Diagnosis by this method is most informative at the period of 21-22 weeks of pregnancy.

Doppler

Amnioscopy

This method is used exclusively from the 37th week of pregnancy, so there is a high risk premature birth. The woman is located in the gynecological chair, the external and internal genital organs are treated with an antiseptic. An amnioscope is inserted through the cervix into the uterus, with its help the doctor examines the condition of the amniotic fluid, the presence of impurities in them.

Counting fetal movements

It is rather a method of primary diagnosis, on the basis of which a pregnant woman seeks a more thorough examination of the body. It has been used since 25 weeks. The woman lies on her side and counts the movements of the baby. Normally, there should be at least 10 movements within an hour.

There is also a Pearson test. At which it is necessary to observe from the moment of awakening until the moment of sleep. For example, let's take the period from 9 am to 9 pm. If during this period you felt less than 10 sessions of movements (they can last for a couple of minutes), then you need to consult a doctor.

Ultrasound examination (ultrasound)

To diagnose hypoxia, ultrasound can be used after 20 weeks of pregnancy. At this time, it is possible to examine the arteries in the uterus and identify disturbances in the work of blood flow with the placenta at an early stage. And also ultrasound is used to determine the structure of the placenta and the level of amniotic fluid.

ultrasound during pregnancy

Treatment Methods

The causes and consequences of hypoxia are quite diverse. In this regard, treatment is selected purely individually, depending on the degree of pathology, concomitant conditions, gestational age and other factors.

Treatment of fetal hypoxia without medication

This technique is aimed at improving blood flow between the mother and fetus, is used on early stages hypoxia or as part of complex treatment:

Decreased physical activity, emotional stress, dosed bed rest. These measures lead to a decrease in the tone in the vessels, which stabilizes the blood flow to the fetus.
Complete nutrition.
Therapy with oxygen. Inhalation of 50% air mixture a couple of times a day. Sometimes oxygen cocktails of 200 ml can be used 10 minutes before meals or 2 hours after.
Hyperbaric oxygenation. A pregnant woman is placed in a special pressure chamber in which she breathes a gas mixture at a pressure above atmospheric. Thus, the level of oxygen access to tissues and organs improves.

Pressure chamber for pregnant women

Medical treatment

Medications for hypoxia are divided into several groups depending on the condition of the pregnant woman and the characteristics of the course of the pathology:

Treatment of the underlying disease of the mother or fetus (diabetes mellitus and others).
Normalization of blood circulation between mother and embryo (Actovegin, vitamins E and C, amino acids).
Preparations for relaxing the muscles of the uterus - Ginipral, Magnesium B6, No-shpa, Papaverine.
To improve blood clotting - Trental, Curantil.

Magne B6 (515 rubles) Actovegin (1048 rubles) Ginipral (245 rubles) Curantil (509 rubles) No-shpa (50 rubles) Vitamin E (123 rubles)

Fetal hypoxia: hospital treatment

Some factors leading to hypoxia may require a pregnant woman to be in the hospital under constant supervision.

Treatment in a hospital occurs in the following cases:

If there is a need to introduce medicines intramuscularly.
Intoxication of a pregnant woman as a result of infections, poisoning. It is important to constantly monitor the condition of the woman and the fetus, as well as replenish fluid losses in the body by introducing intravenous solutions(glucose, sodium bicarbonate and others).
Placental abruption. In a hospital, the condition of the mother, placenta and fetus is monitored. If the treatment does not help, then with detachment in a significant area and heavy bleeding caesarean or cleaning is performed depending on the gestational age.
Infectious diseases of viral or bacterial origin. In this case, antibiotics (Cefazolin, Acyclovir) may be prescribed.

Acyclovir (343 rubles) Cefazolin (24 rubles)

Possible consequences

Intrauterine fetal hypoxia even in mild degree may further lead to backfire for child and mother. First of all, the fetus suffers, since oxygen deficiency negatively affects the development of its organs and systems. Serious degrees of oxygen starvation lead to premature birth and death of the embryo. In this case, the woman in labor often has bleeding, and in the later stages - a difficult birth. In the most difficult situations the woman may have further problems with re-conception.

If a baby with intrauterine hypoxia survived safely the first month after birth, then pathological changes in his future life are minimal.

Chronic

The consequences for a child with a chronic form of hypoxia are as follows:

short stature and underweight;
low hemoglobin;
weak immunity (predisposition to viral infections);
hyperactivity in older age;
poor thermoregulation after childbirth.

Acute

With this form of hypoxia, the following consequences can be observed:

intestinal necrosis;
high risk of the syndrome sudden death babies;
pneumonia;
serious damage to the central nervous system;
development of cerebral palsy.

How to avoid fetal hypoxia?

It is easier to learn how to prevent the risk of fetal oxygen starvation than to deal with the consequences in the future. There are various preventive measures both before the onset of pregnancy (during the period of planning and preparation), and during its course. With a woman's responsible attitude towards this issue the risk of hypoxia is significantly reduced.

Prevention before pregnancy

The main aspects of preparing a woman for pregnancy is the rejection of bad habits(smoking, drugs, alcohol) and examination of the body for the presence of diseases. Treating existing ailments before fertilization will help minimize their impact on fetal development.

During pregnancy

To avoid hypoxia, the expectant mother must adhere to the following rules:

register up to 12 weeks and strictly follow the schedule of required studies;
visit the doctor in the absence of pathologies once a month and a half in the first trimester and once every 4 weeks in the second and third;
observe the regime of the day (sleep at least 8 hours);
complete nutrition;
reception vitamin complexes for pregnant women, especially important folic acid(favorably affects the absorption of iron) and magnesium (responsible for the formation of blood vessels);
walks on fresh air;
healthy lifestyle life.

Not a single mother in the world wants to hear these two words from a doctor - “fetal hypoxia”. Although hypoxia itself is not regarded as an independent disease, it accompanies many serious pathologies in the development of the fetus. Let's figure out what deviations in the development of the baby are associated with chronic oxygen starvation and how to treat them.

Introduction: about hypoxia in general

Hypoxia in the general sense is oxygen starvation of organs. There is less oxygen in the air, less oxygen in the blood, and therefore, less oxygen in the organs - hypoxia. There is a lot of oxygen in the blood, but the cells of the organs stopped absorbing it or the blood itself stopped flowing to the organ - again hypoxia.

Hypoxia can be chronic and acute. Chronic develops slowly, over months. For example, they lived for some time in the mountains with rarefied air and out of habit "caught" chronic hypoxia. And they pinched the finger with a tourniquet, completely stopped the blood supply to it - and acute hypoxia will develop in a few minutes.

The most dangerous hypoxia of the brain. In adults, brain hypoxia is usually chronic. Because of it, chronic fatigue syndrome appears, immunity decreases, sleep and general well-being deteriorate.

In the fetus, the consequences of hypoxia are much more serious. But before moving on to the consequences, let's talk about the causes of intrauterine hypoxia.

Why does fetal hypoxia occur?

The causes of intrauterine hypoxia can be divided into three blocks:

Mother's illnesses
mother's bad habits
Pathologies during pregnancy

Let's quickly go over each of them.

Mother's illnesses
If future mom does not receive enough oxygen, which means that the fetus also lacks it. Some systemic diseases of the mother increase the likelihood of oxygen starvation.

For example, iron deficiency anemia is one of the main causes of fetal hypoxia. With it, the work of hemoglobin, a special carrier protein in blood cells, is disrupted. Because of this, the delivery of oxygen throughout the body is disrupted.

Other risk factors are diseases of the cardiovascular system. They can cause vasospasms, which, in turn, greatly affect the blood supply to organs. If due to spasms worse blood supply fetus, the fetus will receive less oxygen.

Also, the cause of fetal hypoxia can be pyelonephritis and other diseases of the urinary system, chronic diseases of the respiratory system (bronchial asthma, bronchitis), diabetes mellitus.

mother's bad habits
All respiratory tubes in the lungs end in a small bubble - the alveolus. There are thousands of such bubbles in the lungs. And each of them is entangled in thin capillaries. Through the alveolar-capillary membrane, oxygen passes from the air into the blood.

To ensure that oxygen transfer is fast and efficient, the inner surface of the alveoli is coated with a special lubricant. When drinking alcohol, alcohol vapors on exhalation pass through this lubricant and dilute it. Oxygen transfer is disturbed - hypoxia appears in the mother, and hence in the fetus. Not to mention the other consequences that alcohol threatens an unborn baby.

Cigarettes also increase oxygen starvation. The tars in tobacco smoke clog the alveoli and interfere with the synthesis of lung lubrication. A smoking mother is always in a state of hypoxia, and so is her fetus.

Pathologies during pregnancy
It's about misdevelopment placenta and umbilical cord, premature detachment of the placenta, increased uterine tone, overmaturity and other deviations from the normal course of pregnancy. All these are the most frequent and most dangerous reasons fetal hypoxia.

Before that, all the reasons were associated with the mother's body. But intrauterine hypoxia can also be caused by pathologies of the fetus itself. For example, its infection in the womb or malformations.

Separately, it is worth noting the risk of a Rh conflict between the blood of the mother and the fetus. It can cause hemolytic disease. And the consequences of this are not only fetal hypoxia, but also serious problems with the health of the mother.

What is dangerous intrauterine hypoxia

During hypoxia, oxygen in the baby's body is consumed according to an emergency plan. First, life important organs(heart, adrenal glands, brain tissue), then - all the rest. Therefore, with fetal hypoxia, it gastrointestinal tract, kidneys, lungs and skin remain on starvation oxygen rations. And it is in the development of these organs that the first deviations should be expected.

If intrauterine hypoxia was chronic, then after childbirth the child may have problems adapting to external stimuli. They usually manifest through signs such as uneven breathing, fluid retention in the body, convulsions, poor appetite, frequent regurgitation, restless sleep, moodiness.

In the later stages, it can cause serious violations in the central nervous system of the baby: epilepsy, damage to the cranial nerves, disorders mental development and even hydrocephalus. Hydrocephalus, in turn, often leads to torticollis (neck deformity in newborns). This happens because due to hydrocephalus, the baby has a headache, and he tries to turn it so that the pain subsides.
With placental abruption, oxygen starvation develops so quickly that due to acute hypoxia, the child may die.

How to understand that the fetus has hypoxia

The pushing of the baby in the stomach is a joyful event for the mother. But if the jolts are too sharp and strong, they can cause discomfort or even pain. And this is the first wake-up call: too much active movements fetus is the first symptom of hypoxia. So the baby reflexively tries to increase blood flow to himself. The next symptom of fetal hypoxia is, on the contrary, a weakening of tremors up to complete disappearance.
The norm of fetal mobility is at least 10 movements in 12 hours.

Doctors advise to keep a record of his activity, starting from a period of 28 weeks. If the expectant mother noticed that at first the child was actively moving, and then froze for a long time, it is better to go to the doctor.

Obstetricians have a whole range of methods for determining fetal hypoxia:

Listening to fetal heart sounds with a stethoscope. So doctors evaluate the heart rate of the future baby, their rhythm, the presence of extraneous noise.
If there is even the slightest suspicion of hypoxia, cardiotocography is performed using an ultrasonic sensor. With this method, the doctor can evaluate the heart rate in different parameters.
Analysis of the fetal circulation using dopplerometry. This method finds abnormalities in the blood flow between mother and fetus. It allows you to evaluate blood circulation in all parts of the circulatory system of the fetus.
An ECG can also tell a lot about the condition of the fetus.
Doctors also use standard biochemical and hormonal blood tests of the mother.
In addition, if fetal hypoxia is suspected, doctors take for analysis amniotic fluid. If meconium (original feces) is found in them, this is a sign of intrauterine hypoxia. This is due to the fact that due to insufficient oxygen supply, the muscles of the rectum of the fetus relax, and meconium enters the amniotic fluid.

Conclusion: what to do with fetal hypoxia

If all the tests in the hospital still gave a disappointing result, and the doctor suggests the presence of intrauterine hypoxia, the woman must be sent to the hospital for additional tests and, possibly, therapy. In principle, if the condition of the fetus allows you to carry out the same measures at home, then the doctor may let you go home.

We repeat: fetal hypoxia is a serious matter, and its treatment is carried out exclusively under the supervision of the attending physician. Therefore, neither in this article, nor in any other, you will find ready-made recipes for the treatment of intrauterine hypoxia. Maximum - a brief reminder of therapeutic and preventive measures:

The complete rest of the expectant mother, bed rest is strictly necessary. It is recommended to lie mainly on the left side.
The goal of treatment is to provide the baby with a normal blood supply. Specific methods of treatment are selected after the causes of hypoxia and the degree of disturbances in the development of the fetus are clarified.
Drugs that are usually prescribed for fetal hypoxia reduce blood viscosity, improve blood supply to the placenta and normalize the metabolism between the mother's body and the fetus.
If the treatment does not give positive changes and hypoxia continues to progress, then doctors can go for surgery. An important point: caesarean section is possible only for a period of 28 weeks or more.
Prevention of fetal hypoxia must necessarily include a complete rejection of bad habits. Instead, a healthy lifestyle, frequent walks in the fresh air, a balanced diet, reasonable physical exercise without overwork.
Constantly walking on the street will not work, most of the time the expectant mother still spends indoors. Therefore, it makes sense to take care of the fresh air in the apartment. The fastest and best-priced option is to install a compact household appliance in the bedroom.

Each expectant mother can suspect the initial stage of this condition on her own, since she is characterized by very restless behavior fetus. The stronger this pathology develops, the weaker the fetus begins to move. As a result, the woman goes to a specialist doctor.

Held comprehensive examination expectant mother - to assess developmental risks hypoxia fetus:

The pregnant woman is questioned: the age (late or young in the primiparous), the state of health and previous diseases, the outcomes and course of previous pregnancies, the presence of bad habits and other factors are specified.
During the examination, the presence or absence of uterine tone is assessed.
The circumference of the abdomen is measured, then the data is compared with the weight and height of the pregnant woman.
The results of studies evaluating the state of the fetus and uteroplacental blood flow are analyzed.

An accurate diagnosis can be made through such examination methods as:

dopplerometry;
cardiotocography;
study of amniotic fluid;
ultrasonography;
amnioscopy.

Listening to the fetal heartbeat

It is performed through the anterior wall of the abdomen, starting from the 18-20th week of pregnancy. Fine heart rate (HR) in the fetus is 140-160 beats / min.

used obstetric stethoscope- a small tube with wide funnels at both ends. The doctor applies a wide funnel to the mother's stomach - at the point of best listening, which depends on the position of the fetus in the uterine cavity (head, pelvic, transverse).

Cardiotocography (CTG)

It makes it possible to simultaneously record and analyze the fetal heartbeat and uterine contractions.

CTG during pregnancy
With a normal pregnancy after 32-33 weeks, according to the recommendations, it is performed for all women once every 7-10 days.

CTG during childbirth
Execution is determined individually. General recommendations- upon admission of a woman in labor to the maternity ward, after the discharge of amniotic fluid, before stimulating labor in case of weak labor activity and every three hours of delivery.

CTG results are variable and depend on many factors. For example, if in the morning they were within the normal range, then deviations may occur in the evening. Therefore, the study is carried out as often as necessary.

Indications for CTG for women at risk:

From the mother's side: Rh negative blood, the presence in the past of premature birth, reduced or increased fetal activity, serious illness(diabetes mellitus, diseases of the cardiovascular system and others).
Changes in the fetus, identified by ultrasound: impaired blood flow in the placenta, discrepancy between the size of the fetus for the gestational age, anomalies of the placenta and / or umbilical cord, changes in the quality or quantity of amniotic fluid, delay prenatal development, decreased fetal activity.
Complications of the current pregnancy: placenta previa, abnormal position of the fetus, multiple pregnancy, perenashivanie, preeclampsia.

Most often, cardiotocographs record a graph and independently process the data. The doctor makes a decision after receiving them.

There are technologies for conducting CTG-online remotely: the sensor is attached to the skin of the anterior wall of the expectant mother's abdomen, and the signal is transmitted to a smartphone connected to the Internet. The information is received on the Internet portal and processed, and then the results are sent to the doctor for decision making.

There are two types of CTG:

Indirect (external) - carried out with a whole fetal bladder. Sensors are attached to the skin of the anterior wall of the abdomen at the points of best listening to the fetal heartbeats.
Direct (internal) - rarely used, during childbirth in violation of integrity amniotic sac. The sensor for recording the heart rate is attached to the presenting part of the fetus, the catheter for recording the tone is inserted into the uterine cavity.

Duration of CTG recording:

During pregnancy - about 40-60 minutes, when receiving normal indicators - 15-20 minutes.
During childbirth - 20 minutes and / or five contractions.

How is CTG performed?

During the study, the woman is in a sitting or lying position.
The doctor gives the future mother a device with a button, which she presses when she feels the movements of the fetus.

On a note!
It is not recommended to conduct CTG on an empty stomach, within 1.5-2 hours after eating, or one hour after the administration of glucose. If the necessary conditions are not met, the results of the study may be distorted.

CTG options

The non-stress test is carried out in natural conditions.

Stress test - simulated birth process. It is used for additional diagnostics when a non-stress test showed deviations from the norm.

The most commonly used stress test options are:

Oxytocin test: oxytocin is injected and contractions are induced, then the response of the fetal heart rate to uterine muscle contractions is observed.
Mammary test: a woman scrolls her nipples with her fingers until contractions appear.
Acoustic test: the fetal heart rate is recorded in response to a sound stimulus.
The presenting part of the fetus is displaced: the head or pelvis is located closer to the entrance to the uterus for natural childbirth.

Signs of hypoxia on CTG

Assessed on the Savelyeva scale (1984)

Assessment of the state of the fetus by points

8-10 points - normal condition fetus.
5-7 points - there are initial manifestations of hypoxia. A repeated non-stress test is carried out during the day. If the indicators have not changed, then a stress test is performed or additional methods research.
4 points or less - serious changes in the condition of the fetus, which require a solution to the issue of urgent delivery or adequate treatment to improve the condition of the mother and fetus.

Doppler

Blood flow is measured in the vessels of the fetus, placenta and the space between the villi of the placenta.

The study can be carried out from 20-24 weeks of pregnancy, but most reliable results receive from the thirtieth week. The procedure is harmless to the fetus and mother.

A special ultrasound sensor is used, which emits more powerful radiation, which is reflected from a moving object, in this case- blood flow. During the study, the woman is in a position lying on her side or back. Previously, a special gel is applied to the skin of the anterior abdominal wall - for better glide of the sensor.

The study is conducted for all women with a normal pregnancy at 30-32 weeks and before childbirth. Perform more frequently if necessary.

Indications for dopplerometry for women at risk:

From the side of the mother: serious diseases - for example, the cardiovascular system, kidneys, diabetes mellitus and others.
On the part of the fetus: intrauterine growth retardation, a decrease or increase in motor activity.
Condition or complications of the current pregnancy: premature birth, preeclampsia, and others.

Doppler indicators are evaluated by indices, the norms of which depend on the gestational age. The doctor determines the change in blood flow according to special tables.

Violations of the utero-placental-fetal blood flow according to Medvedev

I degree:
A- blood flow is disturbed in the vessels between the uterus and the placenta, but remains at normal levels in the vessels between the fetus and the placenta.
IN- the blood flow in the vessels between the fetus and the placenta is disturbed, but remains between the uterus and the placenta.

II degree: the blood flow is disturbed simultaneously in the vessels of the uterus, placenta and fetus, but the values do not reach critical ones.

III degree: the blood flow in the vessels between the fetus and the placenta is disturbed to critical values, while the blood flow in the vessels between the uterus and the placenta is disturbed or maintained.

Ultrasound examination (ultrasound)

The most common, safe and highly informative method of examination during pregnancy for the fetus and expectant mother.

It is carried out for all women on terms in accordance with the recommendations for a screening study during pregnancy:

The first screening is at 11-13 weeks;
The second - at 20-21 weeks;
The third - at 30-34 weeks.

The principle of operation of the ultrasound machine is based on the fact that the ultrasonic waves sent by the sensor are reflected from the organs under study. Then they are transmitted to the monitor in the form of images that are analyzed by the doctor. During the study, the woman is in the supine position.

The procedure is carried out without prior preparation using two types of sensors:

Transvaginal (a probe is inserted into the vagina) - most often used in the first trimester. Before the examination, the doctor puts on a condom on the ultrasound probe.
Abdominal (they drive a sensor along the skin of the abdomen) - usually used from the second trimester. Before the examination, a special gel is applied to the skin to improve the glide of the probe.

Signs of fetal hypoxia on ultrasound

They are assessed depending on the duration of pregnancy. Changes or diseases that could lead to the development of fetal hypoxia are also detected.

In the early stages, the place of attachment is determined gestational sac and evaluate its formation.

At a later date

Assessing the condition of the placenta

The structure, thickness, place of attachment, presence or absence of detachment, degree of maturity are determined.

Amniotic fluid is examined:

The amount is determined by the amniotic fluid index (AFI), which has a wide range depending on the gestational age. When changing upward we are talking about polyhydramnios, with a decrease - about oligohydramnios.
Attention is drawn to the composition of amniotic fluid: normally, up to 28 weeks, they are transparent and colorless. As the period of water increases, they become cloudy and inclusions in the form of white flakes appear in them - due to the ingress of the separated sebaceous glands of the fetus (fat droplets), vellus hair, desquamation of skin cells and some other substances into them. The appearance of meconium (original stool) is a sign of hypoxia, dirty water, intrauterine infection.

The dimensions of the fetus are determined: head, trunk and limbs.
The data obtained are compared with normal values in accordance with the expected gestational age. On this basis, a conclusion is made. In hypoxia there is intrauterine retention fetal development.

Assessed condition internal organs - to detect developmental anomalies in the fetus.

The position of the child is determined: head, transverse, pelvic.

The structure of the umbilical cord and the location of its loops are assessed- to detect developmental anomalies and possible compression during childbirth.

Amnioscopy

Through the vagina, an optical endoscopic device is inserted into the cervical canal, with the help of which the lower pole of the fetal bladder is examined.

Indications for amnioscopy

Suspicion of post-term pregnancy, acute or chronic hypoxia.
Rh incompatibility between mother and fetus.
Previous pregnancies ended in premature birth or miscarriage, severe gestosis (toxicosis).

The condition of the fetus and the likelihood of hypoxia is assessed by color, transparency and amount of amniotic fluid.

Fetal hypoxia: treatment

There is no standard approach, since much depends on the individuality of the mother's body and the reasons that led to insufficient oxygen supply to the tissues of the fetus.

In the case of a minor form of this pathology, therapy is not provided. If it concerns a severe form of oxygen starvation, then all the efforts of specialists are directed to improving the uteroplacental circulation, as well as to restoring the metabolic processes of the fetus. In addition to numerous medications, the expectant mother can also be prescribed aqua gymnastics along with special breathing exercises. Childbirth in the presence of this pathology is accepted with mandatory cardiomonitoring, which makes it possible to monitor the general condition of the fetus. In very severe cases, an emergency delivery may be necessary, which is carried out by caesarean section.

Treatment of fetal hypoxia without medication

It is aimed at improving the supply of oxygen to the tissues of the mother and fetus.

Reducing physical and emotional stress, compliance with dosed bed rest
It is indicated for existing hypoxia and fetal developmental delay. Helps reduce vascular tone and improves blood flow to the uterus.

Complete nutrition
It is important for the body of the expectant mother to receive all the necessary nutrients.

Hyperbaric oxygen therapy during pregnancy
Oxygen will be used at a pressure that exceeds atmospheric pressure. The procedure is carried out in special medical pressure chambers.

When breathing with a gas mixture under pressure, oxygen delivery to the tissues is artificially improved. Indications for the appointment of the procedure are already developing fetal hypoxia and all the conditions that can lead to it. For example, chronic diseases of the mother (diabetes mellitus, iron deficiency anemia), increased uterine tone and others.

Oxygen therapy during pregnancy
The supply of oxygen to the mother's body is improved by inhaling 40-60% of the oxygen-air mixture 1-2 times a day. It is also recommended to take an oxygen cocktail or foam for 10 minutes, 150-200 ml 1.5 hours before a meal or 2 hours after a meal.

Medical treatment

It has several directions:

Treatment of the underlying disease of the mother by doctors of related specialties - for example, diabetes, respiratory diseases.
Normalization of blood flow in the "mother - placenta - fetus" system.
Relaxation of the muscles of the uterus.
Normalization of fluidity and blood clotting.
Improvement of metabolism in the uterus and placenta.
Complex prescribing of drugs, taking into account one or more reasons and individual tolerability of drugs by the expectant mother.

Fetal hypoxia: hospital treatment

It is carried out with pronounced changes in the uteroplacental blood flow and a lack of oxygen supply to the fetus. Medicines can be administered both in the form of injections and tablets.

Drug group	Representatives	Mechanism of action	Application
Improvement of uteroplacental blood flow
Estrogens	The most commonly used is Sigetin, which has a weak estrogen-like effect. Less often - Follikulin, Sinestrol.	Increase the permeability of the placenta, facilitating the transfer of nutrients and glucose from mother to fetus. Improve metabolism in the endometrium (the lining of the uterus).	Sigetin is administered intravenously, 2-4 ml per 20 ml of 40% glucose solution. If necessary, the drug in the same dose is re-introduced with an interval of 30 minutes (no more than 5 times!). It is not prescribed during childbirth and uterine bleeding. The best effect is achieved with complex use with drugs that dilate blood vessels and improve blood flow.
Drugs that thin the blood, dilate blood vessels and improve blood flow
Antiplatelet agents or anticoagulants	Dipyridamole (Kurantil), Xanthinol nicotinate (Nicotinic acid), Pentoxifylline (Trental)	They inhibit the formation and adhesion of platelets (blood elements involved in clotting). Reduce the amount of fibrinogen - the protein-base of a blood clot (thrombus). Reduce blood viscosity. Improve blood flow in small vessels. Promote the supply of oxygen to the tissues. Moderately dilate small vessels.	Dipyridamole is prescribed 1-2 tablets three times a day. It is used in combination with acetylsalicylic acid. Pentoxifylline - intravenously drip for 7 days in 0.9% saline or 5% glucose solution, then - inside 1 tablet 3 times a day. Xanthinol nicotinate - first intramuscularly, 2 ml for several days, then - 1 tablet orally 3 times a day. The general course of treatment is 2-3 weeks. If necessary, some drugs are used for a longer time, under the control of blood clotting indicators, once every two weeks: fibrinogen, thrombin time, and others.
Drugs that lower the tone of the muscles of the uterus
Tocolytics - to prevent the development of preterm labor	Ginipral, Atosiban (Tractocil), Nifedipine	Reduce the tone and intensity of contraction of the muscles of the uterus. Suppresses premature labor pains, including those caused by oxytocin (the hormone that causes contractions). Ginipral has by-effect: causes an increase in heart rate (tachycardia). Therefore, it is used in conjunction with drugs that normalize the heart rhythm (for example, Verapamil).	Ginipral is first administered intravenously by drip using an automatic infusion pump (liniomat) for 48 hours. Dose: 5 mg in 400 ml of 0.9% saline. Then, if acute contractions stop, the drug is prescribed one tablet every 3 or 4-6 hours. The duration of treatment is determined by the doctor. Nifedipine is prescribed from the 16th week of pregnancy, 1 tablet 2-3 times a day. The duration of use is determined by the doctor. Atosiban is administered intravenously by drip, slowly, in three stages over 48 hours. Causes less side effects, applied from 24 to 33 weeks of pregnancy.
Antispasmodics	No-shpa, Drotaverine, Papaverine	Suppress contractions of the muscles of the uterus, stomach and intestines, urinary tract. Expand blood vessels and improve blood flow.	In the acute period, one of the drugs is administered intramuscularly for several days. Then he recommends the use of papaverine in the rectum in the form of suppositories twice a day. Course - 7-10 days. If necessary, courses of treatment are repeated. In the third trimester of pregnancy, antispasmodics are used with caution. because they can soften the cervix, causing it to dilate prematurely.
Magnesium preparations	Magnesium B6, Magnesium sulfate	Reduce the ability of the muscles of the uterus to contract; Increase blood flow in the vessels of the uterus; Reduce vasospasm; Improve the functioning of brain cells in the fetus and mother; Contribute to lowering blood pressure in the mother; Protect fetal brain tissue from damage: reduce the incidence of cerebral palsy and hemorrhages in the ventricles of the brain during premature birth; Pyridoxine (vitamin B 6) improves protein production.	In preeclampsia and eclampsia, magnesium sulfate is administered intravenously to lower blood pressure, slowly, according to the scheme - in order to avoid overdose. With an increased tone of the uterus and the threat of premature birth, magnesium B6 is prescribed orally, 1 tablet twice a day. The course is 2-3 weeks, if necessary - longer.
Drugs to improve metabolism and increase the resistance of fetal tissues to oxygen deficiency
Antioxidants - protect against damage and improve metabolic processes in maternal and fetal tissues	Vitamins E and C; Amino acids are components for the formation of protein.	They affect all metabolic processes occurring in cells: respiration, energy generation, protein synthesis, and others. They improve the delivery, as well as the absorption of oxygen and glucose by tissues. Prevent the destruction of red blood cells.	Actovegin initially administered intravenously, 4-5 ml per 200-400 ml of glucose solution, every other day. Course - 10 days. Then - one dragee three times a day. Course - 2 weeks. Vitamin E- 1 capsule per day (400 IU / 400 mg) orally during or after meals. Course - 2-3 weeks. Amino acid solutions- 400 ml intravenously, every other day. Course - 5-10 infusions.
Neuroprotectors- drugs that prevent damage to nerve cells in the fetus	Instenon - the most effective drug with minor and unexpressed side effects.	Improves blood circulation in the vessels of the brain; Increases the absorption of oxygen and glucose by the nervous tissue, improves the transmission of a nerve impulse along the nerve fibers; Improves the work of the heart muscle; Expands small vessels.	Instenon is initially prescribed 2 ml per 200 ml of 0.9% saline sodium chloride solution 1 time per day. Course - 5 intravenous infusions daily or every other day. Then - inside 1-2 tablets 3 times a day. Course - 5-6 weeks.

Poisoning, vomiting, diarrhea, intoxication in infectious diseases

Replenished lost fluid by intravenous administration of solutions to restore acid-base balance: glucose, rheopolyglucin, sodium bicarbonate and others.

Premature placental abruption

With a slight detachment on small area And good health future mother observation is carried out in a hospital:

The state of the fetus, mother and placenta is monitored in dynamics. Studies are being carried out: CTG, dopplerometry, ultrasound and others.
Treatment is prescribed: contractions of the muscles of the uterus are suppressed, hemostatic agents (Decinon, Vikasol), antispasmodics (No-shpa, Papaverine), drugs to improve metabolism and protect the fetus from lack of oxygen are prescribed.

Detachment over a large area with the development of massive bleeding or the appearance of minor repeated spotting from the birth canal

Regardless of the mother's well-being, an urgent delivery is performed, a caesarean section is preferable. Induction of labor in placental abruption is contraindicated.

With massive bleeding of the mother, a donor red blood cell mass (a suspension of red blood cells obtained from human blood) and plasma (the liquid part of the blood) is injected to replace the volume of lost blood and normalize its coagulation.

Infectious bacterial and/or viral diseases

For bacterial infections, antibiotics are prescribed depending on the pathogen that caused the development of the disease, according to the gestational age. The most commonly used are cephalosporins (Cefazolin, Ceftriaxone), penicillins (Ampicillin, Amoxiclav), macrolides (Erythromycin, Vilprafen).

At viral infections during pregnancy, Viferon is allowed for use from the 16th week of pregnancy, Acyclovir - with caution, Genferon - from the II and III trimester.

To improve performance immune system in chronic infections, membrane plasmapheresis is recommended. During the procedure, the liquid part of the blood (plasma) is filtered through a special membrane with holes of different sizes, due to which large molecules containing toxins, allergens and other elements of inflammation are retained in the membrane.

Indications for urgent delivery with fetal hypoxia

Lack of effect from the treatment.
Deterioration of indicators on studies: CTC, dopplerography and others.
The appearance of meconium in the amniotic fluid, the increase in oligohydramnios or polyhydramnios.

Preference should be given to caesarean section, but it is also possible to use obstetric forceps, depending on the condition of the fetus and mother.

Fetal hypoxia: treatment at home

It is carried out after the main treatment in a hospital or on initial stages hypoxia with unexpressed changes. A prerequisite: the ability to monitor the effectiveness of the treatment: CTG, ultrasound and others.

The same drugs are used as in the hospital, but they are prescribed in the form of tablets, capsules for oral administration, suppositories for injection into the rectum.

Hypoxia during childbirth - asphyxia of the newborn

Resuscitation activities are carried out in the delivery room.

The order in which the steps are performed depends on two factors:

The severity of asphyxia (suffocation) on the Apgar scale - is used to assess the condition of the child only at birth.
The effectiveness of the previous steps.

After birth and crossing the umbilical cord, the child is transferred to a heated table, wiped with dry heated diapers to avoid hypothermia and increased hypoxia.

Patency is restored respiratory tract: mucus and amniotic fluid are sucked out from the mouth and nose of the child with the help of a rubber pear or electric suction. Then, if necessary, the neonatologist or obstetrician-gynecologist flushes saline respiratory tract of the child from meconium and amniotic fluid using an electric pump and a laryngoscope (a medical instrument with a light).

With no or irregular breathing a tube is inserted into the child's airways to supply an air-oxygen mixture - intubation. Artificial ventilation of the lungs begins with the help of a special balloon, if necessary, with simultaneous chest compressions.

After stabilization of the general condition, the child is transferred from the delivery room to the neonatal intensive care unit for further treatment.

Indications for terminating neonatal resuscitation:

Lack of heart work for 8-10 minutes.
There is cardiac activity, but breathing is not restored within 15-20 minutes.

Fetal hypoxia during childbirth (newborn asphyxia): rehabilitation by hypothermia - video

Consequences

The severity and frequency of complications of oxygen deficiency for the fetus depend on the duration of pregnancy, the duration and strength of exposure to damaging factors (the degree of hypoxia).

Chronic fetal hypoxia: consequences

In the first trimester the laying of organs and tissues is disturbed, which leads to the formation of congenital malformations. Changes incompatible with life lead to intrauterine death of the fetus and miscarriage in the early stages. With the further development of pregnancy, a child is most often born with various congenital malformations. For example, with anomalies in the development of the brain, kidneys, lungs, etc.

In the second and third trimesters
There is a delay in intrauterine development of the fetus: insufficiency of weight and / or growth.

Perhaps the beginning of the development of labor activity much earlier than the expected date - the birth of a premature baby.

Often there are foci of hemorrhage in various organs and ischemia (areas of tissue experiencing a pronounced decrease in blood flow), necrosis develops (areas of tissue death), there is immaturity of organs and systems. Without a trace, such changes do not pass, and the consequences can persist throughout life.

Manifestations depend on the affected organ and/or tissue:

nervous system- possible development of epilepsy (sudden onset of seizures), cerebral palsy (damage to one or more parts of the brain), lag in mental development, violation of the process of maturation of the nervous system after birth and other diseases.
internal organs - after birth, the child does not adapt well to new conditions of life outside the womb. For example, physiological jaundice lasts longer, there is a tendency to respiratory diseases, the functioning of the immune system and other changes are disrupted.

Often, the condition of such children at birth is severe, requiring treatment in the conditions of resuscitation of newborns from the first minutes of life. In the future, these children need long-term recovery period and treatment by specialized specialists - for example, by a neuropathologist.

Consequences of acute fetal hypoxia

Develop depending on the severity of the impact of the cause:

Maybe thickening of the blood and decrease in its volume, which leads to insufficient supply of oxygen and nutrients to the tissues. Against this background, hemorrhages, ischemia and necrosis of individual tissue sections in various organs occur. First of all, in the brain and adrenal cortex (they produce hormones that are responsible for almost all metabolic processes).
Massive blood loss because of premature detachment placenta. Consequences for the child: birth in a state of hemorrhagic shock (bleeding), in which the work of all organs and systems suffers. Consequences for the mother: Couveler's uterus (soaking with blood) and the development of DIC (increased tendency to bleed). Both the fetus and the mother may die.
If the airways are not cleared in time from amniotic fluid and meconium, the death of a child due to asphyxia and the development of pneumonia in the first days of life is possible.

Prevention of fetal hypoxia

Long before pregnancy:

Treat chronic diseases or achieve stable remission (disappearance or significant weakening of the signs of the disease). Since any slight exacerbation of the disease during pregnancy can lead to a violation of the general condition of the expectant mother and harm the fetus.
Give up bad habits: smoking, alcohol abuse, drug use.

During the onset of pregnancy:

Registration up to 12 weeks of pregnancy with the implementation of all necessary studies according to the terms of pregnancy.
A visit to an obstetrician-gynecologist in a antenatal clinic according to the recommended terms: with a normal pregnancy in the first trimester - once a month, in the second and third trimesters - once every two to three weeks.
Compliance with the regime of wakefulness and rest: night sleep for at least 7-8 hours.
Complete nutrition with foods that contain sufficient vitamins, minerals, proteins and fats.
Taking vitamin preparations that are involved in all body processes. The most important for the expectant mother is folic acid (vitamin B 9). It promotes the absorption of iron, is necessary for the development of all organs and systems in the fetus, significantly reduces the likelihood of the formation of malformations of the nervous system.

Intrauterine fetal hypoxia is an insufficient supply of oxygen to a child in the womb. There are acute and chronic forms of this condition. Recently, there have been more and more cases of oxygen starvation of the fetus. About ten percent of all women giving birth hear this diagnosis from a doctor.

The lack of oxygen supply to the baby can be fixed at different months of gestation. The consequences of hypoxia for the child also depend on the period.

If oxygen starvation is detected in the first trimester, then there is a risk of anomalies in the development of various vital systems of the fetus. IN last trimester it causes growth retardation, underweight, and most importantly, it can negatively affect the central nervous system of the baby after birth.

In the event of signs of hypoxia, the fetus is strenuously trying to maintain the required level of blood flow. The heart rate immediately increases to 150-170 beats per minute. A child in the womb has a completely unusual structure of fetal hemoglobin (fetal). It is able to capture oxygen from the blood and effectively retain it.

An insufficient amount of oxygen in the blood causes an acceleration of all processes of the fetal life support system. The brain, kidneys, liver begin to work in an enhanced mode. Meconium can come out of the intestines - this is the original stool. Swallowing it is fraught for the child with complications in the gastrointestinal tract.

In a two-month-old embryo, feeling a lack of oxygen, there is a delay in the development of the brain. Gradually, negative changes occur in the work of the cardiovascular system.

When identifying mild form hypoxia is nothing to worry about. It won't affect the baby in any way. A baby in the womb is able to cope with a slight lack of oxygen.

Forms of hypoxia:

Causes of intrauterine hypoxia

There are a huge number of factors affecting the development of oxygen deficiency in the fetus. But forewarned is forearmed. Possession of knowledge about the causes of hypoxia will help future parents to prevent this condition.

Diseases of a pregnant woman

Diseases	Description
Anemia	If a woman who is expecting a child has low hemoglobin in the blood, then the fetus feels a sharp lack of oxygen
Heart defects, dysfunction of the heart muscle, myocardial diseases, chronic bronchial diseases	During gestation, the entire body of a woman works in emergency mode, a large load falls on the heart and lungs. The cardiovascular system pumps blood for two, and the lungs supply oxygen to both mother and baby. If these organs are not able to fully perform their work, then circulatory failure appears. This leads to hypoxia.
Gestosis or toxicosis	May lead to exfoliation of the placenta and provoke hypoxia

In this case, the process of normal blood flow through the placenta to the fetus will be disrupted. Anomalies in the development of the placenta or umbilical cord tissue may appear.

If the birth did not occur at the appointed time, the pregnant woman is placed in the hospital to prepare for delivery. There, obstetricians monitor the child, since the result of most post-term pregnancies are children with severe oxygen starvation. By the end of the term, the placenta is aging, it can no longer supply the child with the necessary amount of oxygen. If childbirth does not come by itself, they are caused by special means.

Pathologies of fetal development

The incompatibility of the blood type of mother and baby causes hemolytic disease.

If a child is infected in the womb, then various disturbances in the functioning of vital systems may appear.

Difficult childbirth

Complications during childbirth can lead to a long stay of the child in the birth canal. Squeezing the baby's head or entwining the neck with the umbilical cord causes him a sharp oxygen deficiency. hard pass natural childbirth a large fetus or with its occipital or pelvic presentation.

Weak labor activity, lack of contractions, discoordination of labor - all these are the causes of fetal hypoxia.

How to recognize hypoxia

the mother should be alerted by the sudden enthusiasm for the activity of the fetus. The kid often rolls over, kicks, becomes restless;
after the peak of activity, its sharp decline occurs, the intensity of movements decreases. The child pushes rarely, weakly;
to determine if there is a reason to worry, you need to conduct a movement test: if the baby showed activity three times or less per hour, this is a reason to contact your gynecologist.

Diagnostics of the state of oxygen starvation

№	Diagnostics	Description
1	Doppler	Blood flow velocity analysis
2	fetal ultrasound	One of the most important tests during pregnancy. Helps to control the state of the embryo, the amount of amniotic fluid, their consistency, the degree of maturation of the placenta, heart rate. Ultrasound shows whether all the baby's organs are developing according to the gestational age. The study reveals the state of hypoxia in the fetus
3	CTG procedure	Assesses the baby's motor activity, his heartbeat
4	obstetric stethoscope	A special tube with which the gynecologist listens to the baby's heartbeat at each appointment, draws conclusions about its rhythm and clarity of tones
5	Baby tracking	This diagnosis is carried out every day by the expectant mother herself. The child must be active every day. If the baby is not active for three or four hours, then you should immediately contact the antenatal clinic or the nearest maternity hospital. They will immediately conduct a study of the fetus, listen to its heartbeat, do an ultrasound and make sure that everything is in order with the child.
6	Timely registration in the antenatal clinic and a systematic visit to the gynecologist	Monthly for the first three months, biweekly for months 4, 5, and 6, and weekly for the final terms

Treatment of hypoxia depends on the history, causes, gestation period. The treatment regimen is prescribed by a specialist individually. There is no prescribed treatment algorithm. General doctor's recommendations may be:

improving the general well-being of a woman waiting for a baby. If possible, they begin to treat chronic forms of diseases, increase low hemoglobin in the blood, stabilize blood pressure;
adherence to the correct daily routine. Sleep - at least eight hours. Walks in the fresh air, small physical activity;
it is important to adhere to a well-chosen diet;

elimination of bad habits, including coffee;
in violation of plasma coagulability, anticoagulants are started;
with a low level of hemoglobin in the blood, the specialist prescribes iron-containing complexes (Ferrum-Lek, Maltofer), vitamins for pregnant women (Complevit, Elevit Pronatal);
for blood thinning, Curantyl is often prescribed;
with weak labor activity, the hormone oxytocin is injected into the body of the woman in labor. It enhances contractions, normalizes the tone of the muscles of the uterus. If oxygen deficiency is associated with increased tone uterus, then the introduction of the hormone is stopped;
during childbirth, a woman can be given oxygen through a special mask;
amnioinfusion. The procedure for introducing a substance into the amniotic fluid that can prevent the development of oxygen starvation and the ingestion of original feces;
if a woman has hypertension, then intravenously she is given droppers with magnesia. It has a positive effect on the fetus, prevents the risk of hypoxia;
when the mother or fetus is infected, antimicrobial agents, anti-inflammatory drugs are started. How used to be a woman consult a doctor and start therapy, the higher the likelihood of curing the child;
correct and timely choice of the method of childbirth. Large fruit or narrow pelvic bones mothers are indications for caesarean section. Otherwise, acute or fulminant hypoxia may develop;
in the chronic form of hypoxia throughout pregnancy, they artificially improve metabolic processes (doses of vitamin E) and cell permeability. If no improvement is observed, then at the seventh month of pregnancy, a decision is made on surgical intervention. Carry out a caesarean section.

Video - fetal hypoxia: causes and consequences

Lack of oxygen can be dangerous for the life and health of the baby. During pregnancy, the expectant mother must carefully monitor her condition. Also, visits to the gynecologist should not be neglected. Regular examinations by specialists reduce the risk of fetal hypoxia. It is necessary to responsibly approach the choice of a specialist who will guide a woman for all nine months. The high qualification of the doctor and the positive experience of managing pregnancy is a guarantee of successful detection of pathologies and a quick response to emerging problems.

A woman in position should avoid stress and unrest. Strong experiences negatively affect the emotional state of the pregnant woman and can negatively affect her health and the development of the unborn child.

Attentive attitude to one's condition, absence of stressful situations and regular visits to the attending physician make it easier to cope with any manifestations of oxygen deficiency and take care of the baby's health.

Prevention of the occurrence of oxygen starvation of the fetus and other pathologies of the course of pregnancy is its proper planning.

How to avoid? If you undergo an examination before conception and treat all existing diseases, then the risk of hypoxia will significantly decrease.

Another important point in the prevention of hypoxia is maintaining a healthy lifestyle of parents before conception and during gestation.

A pregnant woman must definitely give up smoking, alcohol, eat right, have a good rest, maintain physical activity, but not overwork. Stress and anxiety should be avoided. The health of the unborn child directly depends on the health of the mother.

If a woman has incurable chronic diseases, then she needs to inform the doctor about this so that he knows about possible problems during pregnancy and can take the necessary actions to eliminate them in time.

Well help for the prevention of hypoxia long walks in the fresh air, breathing exercises, airing the room where the woman is. After all, in order for the child inside the womb to receive enough oxygen, a woman needs to inhale more of this gas.

In urban conditions, this is not always possible, because the air in cities is saturated with carbon dioxide, an oxygen antagonist. Therefore, it is better to walk in city parks, near water bodies, and go out of town.

Aqua gymnastics has proven itself positively. This is the most safe view sports for pregnant women. Water will help to relax and relieve stress, tones and uplifts the mood. Exercises in water will help improve blood circulation, the functioning of all organs and systems of the body, and improve metabolism.

Classes in the pool train the respiratory and cardiovascular systems, saturate the blood with oxygen, which serves as a good prevention of hypoxia. Also, exercises will help relieve the load from the spine, which is very important during pregnancy, train many muscles, including the back, abs, and hips.

For the timely detection of hypoxia, it is important to take all prescribed tests on time, monitor the health of a pregnant woman and consult a doctor.

Consequences

What does this lead to in the future?

In the absence of timely diagnosis and adequate treatment, prolonged oxygen starvation can lead to the following consequences:

In the first trimester, the slowdown and fading of pregnancy;
Improper formation of systems and organs of the child;
Fetal retardation in development and growth;
CNS lesions;
Decreased function of adaptation of the newborn to the environment.

In our following material you will find

acute form

emergence acute form oxygen starvation occurs suddenly and develops rapidly. Development takes place over several hours.

You can suspect hypoxia that has arisen during delivery:

If the amniotic fluid has a greenish color, it is cloudy with an admixture of the baby's feces - meconium.

With a severe oxygen deficiency in the blood of the fetus, the child's circulatory system redistributes oxygen so that it enters the most important organs. In this case, the function of the intestine decreases, and the stool passes into the amniotic fluid. IN normal flow, the baby first defecates after birth.

If the child's heart rate first increases sharply (up to 170 beats per minute and above), and then decreases (up to 120 beats per minute and below).

The rhythm becomes weak, the heartbeat is muffled, arrhythmic.

Causes

Most common causes the appearance of acute oxygen deficiency in the fetus during labor can become:

Premature placental abruption

Most often occurs with preeclampsia - long-term high blood pressure woman

The uterus ruptures during childbirth

With pathological changes in the walls of the uterus or by mechanical damage). In this case, the fetus, along with the placenta, enters the abdominal cavity of the mother and dies within a few minutes.

Difficult delivery with difficult exit of the child

The baby's head is squeezed for a long time, especially if the baby is overweight

Clamping of the umbilical cord

It is most often caused by repeated entanglement of the umbilical cord, especially around the baby's neck. In this case, asphyxia may develop.

Prolonged labor, low labor activity.

Treatment

Treatment of acute hypoxia depends on the causes of its occurrence. In any case, urgent medical intervention, usually surgery, is required.

If an acute form of the disorder occurs during pregnancy, it is urgent to take the pregnant woman to the hospital.

To improve her condition, intravenous administration of glucose, vitamins, and means to stimulate respiratory function can be used.

In acute fetal hypoxia that occurs during childbirth, it is necessary:

If possible, eliminate the cause that caused this condition

For example, to stimulate childbirth with their protracted nature, or to perform an emergency operation.

Provide the necessary resuscitation for the newborn immediately after birth.

In an infant with acute hypoxia, asphyxia usually occurs - lack of breathing. Oxygen starvation causes the accumulation of carbon dioxide in the organs and tissues of the newborn, slowing down breathing and heartbeat until they stop.

In the future, the child is placed under the control of specialists, examinations are prescribed to detect affected organs, systems, tissues due to oxygen deficiency.

Consequences

Acute development of hypoxia in case of failure emergency assistance can lead to the death of a child.

The consequences of acute oxygen starvation that occurs during childbirth are assessed using the Apgar scale. The lower the scores on this scale, the greater the likelihood of pathologies and health disorders in the newborn.

The consequences of oxygen starvation can be expressed by the following pathologies:

CNS lesions in a child

The lack of oxygen leads to the death of nerve cells, which, as you know, are not restored.

Ischemic diseases of organs and tissues

Who have suffered due to oxygen deficiency;

Hemorrhages in various organs
Increased risk of sudden infant death

Prevention

It is impossible to predict the occurrence of an acute form of hypoxia. However, steps can be taken to reduce the risk of developing this pathology.

Prevention of acute oxygen deficiency is proper preparation to pregnancy and childbirth, prevention chronic hypoxia. Moderate physical activity and a healthy lifestyle reduce the risk of complications in childbirth, and, consequently, the occurrence of hypoxia.

It is important to choose an experienced obstetrician who will take care of the birth. Inform him about the course of pregnancy, problems during its period, existing diseases that can cause complications in childbirth.

The doctor will help you correct solution about how to resolve childbirth or provide timely assistance in case of problem situations.

Peace, only peace! Fetal defense mechanisms

Despite the fact that fetal hypoxia is a fairly common diagnosis, do not worry ahead of time. Of course, oxygen starvation is very harmful to the child, but there is no need to panic ahead of time. After all, nature provides for compensatory-adaptive reactions of the fetus. They are expressed by such physiological features:

Increased heart rate to 130-160 beats per minute,
Blood contains a lot of fetal hemoglobin, up to 70% of the total volume,
There is a significant oxygen capacity of the blood,
the cardiovascular system of the fetus is designed so that almost all organs receive mixed blood

which provides more slow decline oxygen levels in the blood during hypoxia.

When oxygen starvation occurs, the stroke volume of the heart increases, the heart rate and circulating blood volume increase, the blood supply changes so that the main volume of blood enters the vital organs - the brain, heart, lungs - and blood circulation in the skin, muscles, and intestines decreases.

The stress that occurs in the fetus during hypoxia activates the body's systems, causes the release of glucocorticosteroids, which increase the stability of cell membranes.

Thus, at the first stage of hypoxia, the fetus is quite capable of maintaining the required level of oxygen in the tissues. And only with prolonged oxygen deficiency, the fetus's adaptive mechanisms are depleted, and decompensation develops, which means that oxygen starvation of cells occurs.

The main thing for a pregnant woman is to remain calm, not to succumb to emotions. After all, from emotional state depends on the health of both mother and child.

It is important to study all available information on hypoxia during pregnancy, to know its symptoms and to be prepared for the occurrence of this problem. Then it will be possible to identify the violation in time and eliminate it even before the appearance of serious consequences.

Video about prevention methods

From next video You will learn how you can increase the flow of oxygen to your baby.