Prevention of oxygen starvation in the fetus. How to understand that the fetus has hypoxia. Acute and chronic fetal hypoxia

Fetal hypoxia is a multiple organ syndrome associated with oxygen starvation of the fetus during prenatal development, characterized by a complex pathological changes from many organs and systems.

Fetal hypoxia is recorded on various stages intrauterine development and is diagnosed in every tenth case of pregnancy. The development of the fetus as a whole and the process of formation of individual organs and systems depend on the degree and duration of oxygen deficiency. Severe and prolonged hypoxia can result in intrauterine death of the fetus or the formation of various severe congenital anomalies. First of all, the brain, central nervous system and adaptive abilities of the newborn suffer, but changes can affect any other organs.

Until the moment of birth, the fetus does not breathe independently, the lungs are filled with fluid until birth. The only source of nutrition and respiration for the fetus - the placenta, into which nutrients and oxygen come from the mother's blood. If oxygen transport is disturbed at any stage, oxygen starvation of the fetus occurs, hypoxia develops.

Fetal hypoxia is a dangerous condition that requires immediate medical intervention and correction of the health of the pregnant woman in order to prevent the development of complications and preserve the life and health of the fetus.

Causes

The development of hypoxia is provoked by many factors, therefore it is not always possible to unambiguously indicate the cause and exclude it in advance. There are factors and risks for the development of hypoxia, relative causes that are identified before the onset of a dangerous condition. It is aimed at fighting them. preventive work obstetrician-gynecologist and the pregnant woman herself.

Fetal hypoxia develops with the onset of a number of factors related to the health of the mother, the fetus, or damage to the placenta.

The most common causes of hypoxia:

anemia;
arterial hypertension;
heart disease, heart failure and other diseases of the cardiovascular system;
kidney disease, chronic kidney failure;
respiratory diseases - bronchitis, tuberculosis, pulmonary emphysema, oncology, etc.;
bronchial asthma;
diseases immune system, immunodeficiency;
diabetes;
endocrine diseases;
multiple pregnancy;
STD;
toxicosis;
alimentary dystrophy, exhaustion due to lack of nutrition of the mother, etc.

Insufficient supply of oxygen to the fetus is provoked by chronic intoxication, including industrial intoxication (therefore, it is highly undesirable for pregnant women to work in industries with high emission harmful substances into the atmosphere, in the paint and varnish industry, in many enterprises where there is contact with a large amount of harmful substances). Other sources of chronic intoxication of the mother's body and, as a result, the fetus are alcohol abuse, nicotine and drug addiction.

On the part of the state of health of the fetus, the causes of hypoxia can be:

congenital genetically determined anomalies;
hemolytic disease;
intrauterine infection;
entanglement of the umbilical cord;
fetoplacental insufficiency;
head compression;
intrauterine trauma.

Rh conflict with a different Rh factor in the mother and unborn child usually occurs in the second and subsequent pregnancies, if different Rh factors already had a mother and firstborn. If the Rh factors of the mother and the first child coincided, then the likelihood of an Rh conflict during the second pregnancy is not so great.

After the 6-11th week of pregnancy, hypoxia provokes disorders in the formation of the brain and central nervous system, disorders in the structure of blood vessels, and the blood-brain barrier. Problems of maturation and formation can affect the kidneys, skeleton, heart, lungs, intestines and other organs.

Hypoxia does not always lead to serious problems. Short-term and insignificant oxygen starvation is successfully compensated for in the following weeks, but if hypoxia becomes chronic or protracted, then the risk of complications increases many times over.

Classification

According to the duration of the course and the rate of development, hypoxia is usually divided into acute and chronic.

Acute hypoxia is more often observed in complicated difficult labor and is associated with prolonged or, conversely, rapid labor, prolapse or pressing of the umbilical cord, prolonged fixation and squeezing of the head. Acute hypoxia develops with placental abruption and uterine rupture.

Chronic hypoxia is associated with a long-term violation of the supply of oxygen to the fetus. Any of these factors provokes a violation of the blood supply to the fetus through the placenta or depletion of blood with oxygen, a violation of oxygen absorption by the fetus. All this leads to the development of chronic hypoxia and its complications.

Apgar score

In 1952 american doctor Virginia Apgar proposed a scale for assessing the state of the newborn in the first minutes after birth.

Not always low Apgar scores are due to hypoxia of the fetus or newborn, but very often bad condition newborn due to oxygen starvation.

According to the Apgar scale, five objective criteria are subject to assessment from 1 to 3 points:

Skin coloring.
Heart rate.
reflex activity.
Muscle tone.
Breath.

A score of 8-10 points is considered excellent, this is the norm at which you can not worry about the health of the baby. A score of 4-7 points requires attention from the obstetrician. A reassessment is made five minutes after birth. Usually it rises to 8-10 points, if not, then a careful examination of the baby by a neonatologist is required and a decision is made on additional measures. This is moderate hypoxia, which needs to be compensated, but usually does not lead to serious consequences. 0-3 points - asphyxia, severe hypoxia, requiring emergency measures, resuscitation.

Symptoms

In the first weeks, it is very difficult to recognize hypoxia, it practically does not manifest itself in any way. The presence of risk factors forces a woman and an obstetrician-gynecologist to monitor the health of the expectant mother with increased attention, to make an indirect assessment of the condition of the fetus. It is necessary to compensate for possible anemia, to provide good nutrition, rest and stay on fresh air.

After the 20th week, the already ripening fetus begins active life, the severity and intensity of which can be used to judge its condition. If the fetus suddenly becomes less active, moves less and “kicks”, then this may indicate the beginning of development oxygen starvation, you should immediately consult a doctor for a full diagnosis.

The initial stages of the development of hypoxia are manifested by tachycardia - increased heart rate. The progression of oxygen starvation is evidenced by bradycardia (decrease in heart rate) and a decrease in activity, heart tones are muffled. In the amniotic fluid, impurities of the original feces, meconium may appear. This indicates severe fetal hypoxia and requires emergency measures to save the life of the unborn child.

Diagnostics

At the first signs of hypoxia, the doctor conducts auscultation of heart tones and fetal heart rate. With severe symptoms of tachycardia or bradycardia, further targeted examination is necessary.

Cardiotocography and phonocardiography allow you to determine the fetal heart rate, its activity. With the help of dopplerometry, uterine placental blood flow it is possible to assess the state of the fetal blood supply due to the speed and characteristics of blood flow in the vascular bed of the umbilical cord and placenta. An ultrasound examination reveals a delay in the development and growth of the fetus, oppression motor activity. Many or low water are indirect evidence and predisposing factors for the development of oxygen starvation.

Amnioscopy and amniocentesis can assess amniotic fluid, their color, transparency, the presence of impurities, make biochemical samples.

Treatment

When diagnosing fetal hypoxia, a woman needs hospitalization. The fight against obstetric-gynecological and somatic pathologies of the pregnant woman and the correction of the fetoplacental circulation are carried out on a stationary basis. You need complete rest, good nutrition, the exclusion of any external stimuli.

To correct uterine hypertonicity, papaverine, eufillin, drotaverine and other antispasmodic drugs are prescribed. To reduce intravascular blood clotting - dipyridamole, pentoxifylline, etc.

Preparations that contribute to the normalization of intracellular permeability - vitamins E, C, B6, glucose, glutamic acid, antioxidants, neuroprotectors.

As additional method treatment and prevention are prescribed UVI, breathing exercises, inductothermy.

After childbirth, all children are subject to constant monitoring by a neurologist, a pediatrician, and, according to indications, an orthopedist, a pediatric cardiologist, a pediatric gynecologist, a speech therapist, a child psychiatrist.

Correct and timely prevention of fetal hypoxia consists in the preliminary selection of obstetric care and the correct management of childbirth, constant monitoring of the state of the pregnant woman and prevention birth trauma And intrauterine infections, but first of all it is necessary to pay due attention to the collection of an anamnesis of a woman and her examination.

During the gestation period, the child is not able to breathe on its own. The lungs are not yet fully formed and filled with fluid, so oxygen, like nutrition, comes through the placenta.

What is fetal hypoxia during pregnancy?

Fetal hypoxia during pregnancy is a lack of oxygen that occurs due to various pathological processes.

Hypoxia in the fetus during pregnancy occurs as a result of prolonged lack oxygen. In the early stages, pathology can cause delayed development, since it is during this period that all the main internal organs are formed. On later dates- negatively affects the central nervous system embryo.

As a result of oxygen starvation, the baby's body begins to compensate for the deficiency with its own resources, its heart rate rises to 160 beats / min to improve blood flow. If the process is not diagnosed in a timely manner, then a developmental delay is formed, both physical and mental.

In medical practice, chronic and acute types of pathology are distinguished, which differ in the duration of exposure and the period of occurrence.

Chronic hypoxia of the fetus during pregnancy is caused by the consequences, expressed in underdevelopment internal organs and poor adaptation in the postpartum period.

Acute pathology occurs during labor activity and endanger the life of the baby. Prolonged childbirth, with infection or open bleeding, causes almost suffocation (asphyxia) and requires emergency medical intervention.

Fetal hypoxia during pregnancy: signs, symptoms and consequences

It is quite difficult to learn about the formation of hypoxia in the early stages. Only a doctor will be able to identify and suspect a blood test, where the results will show signs of anemia (lack of hemoglobin).

You can independently recognize the symptoms only after 16-18 weeks of intrauterine development, when the baby begins to move. In the later stages, the lack of oxygen is determined by reduced motor activity. Feelings of almost imperceptible stirring and rare tremors of the baby are formed.

To diagnose the pathological process, more accurately, you can use special studies:

Ultrasound helps to determine developmental delay, while measuring the height, weight and volume of the child. To understand the functioning of the placenta, the walls of the embryonic organ are measured.
Dopplerometry allows you to notice circulatory disorders in the uterine arteries and placenta, which indicates insufficient oxygen delivery. Often there is bradycardia (slow heartbeat), so the diagnosis becomes clear from the heart rate.

After 30 weeks, cardiotocography is used for diagnostic purposes. Among the laboratory examinations, amnioscopy is prescribed, as well as hormonal and biochemical tests.

Symptoms and consequences depend on the severity. With prolonged hypoxia, tissue respiration is disturbed, vital important organs unable to develop normally. There is a risk of intrauterine death of the embryo, suffocation and serious birth injuries.

Reasons for the formation

The reasons can be very diverse. The main factor that causes pathology is anemia - a decrease in hemoglobin in the blood and the inability to deliver required amount oxygen to the baby.

Other reasons include:

respiratory, cardiovascular or blood diseases in the mother;
Rh blood conflict;
infections and viruses in a woman's body;
heredity;
clamping or entanglement of the umbilical cord;
prolonged toxicosis;
conception of more than one fetus;
premature detachment and aging of the placenta.

Polyhydramnios also causes difficulties in metabolism and requires timely treatment.

How to avoid fetal hypoxia during pregnancy?

In order to avoid the disease, it is necessary to prepare in advance for future conception. Eliminate bad habits, adjust the diet and get tested for infectious diseases.

Timely control and competent management of intrauterine development will help prevent the formation of pathology. Prevention is early detection and complex therapy, which is aimed at normalizing the placental circulation.

Helps prevent disease bed rest, positive emotions and drugs that improve blood circulation. May be recommended special gymnastics With breathing exercises to reduce the tone of the uterus and increase metabolism.

How and how to treat fetal hypoxia during pregnancy

Before starting treatment, doctors find out the fundamental factor that led to the disease, and starting from the causes and the diagnosis, complex therapy is prescribed.

Treatment of fetal hypoxia during pregnancy involves the use of drugs that help:

expand the vessels - eufillin, no-shpa;
reduce the tone of the uterus - ginipral, magne B6;
increase the functionality of blood circulation - trental, actovegin;
normalization of metabolism - amino acids and proteins;
stabilization of cell permeability - Essentiale, hofitol;
increased protective functions - antihypoxants, neuroprotectors.

To prevent the formation of blood clots and normalize the immune system of a woman, chimes are often prescribed. The drugs are used only in accordance with individual features which have no contraindications and negative consequences.

Fighting the disease in the third trimester, after the 28th week, when the baby's condition is rapidly deteriorating, does not make sense. In such a situation, doctors face the question of whether to do C-section? Since only such a method, urgent delivery, can save the life of a child.

In the process of labor activity, CTG is used, if during gestation a long period hypoxia was observed. Thus, constant control over the condition of the fetus is ensured, and the newborn is born under the supervision of specialists.

Intrauterine fetal hypoxia- a pathology characterized by a lack of oxygen in the body of the unborn child. Deficiency of this chemical element leads to disturbances in cell metabolism, and later to their death. Fetal hypoxia is the cause of intrauterine growth retardation and development of the unborn child, congenital anomalies of the central nervous system and the death of the baby.

Diagnosis of oxygen starvation of the fetus is one of the main tasks of each appointment of an obstetrician-gynecologist. Timely detected pathology provides selection proper treatment and prevention of severe complications.

Fetal blood supply

In the womb of the mother's body, the lungs of the unborn child are in a collapsed state and do not participate in the act of breathing. The supply of oxygen and the removal of carbon dioxide is provided by the vessels of the umbilical cord. It contains two arteries that carry venous blood (poor in oxygen), and one vein that carries arterial blood(rich in oxygen).

One end of the umbilical cord faces the fetus and is fixed in its anterior abdominal wall. The opposite part of the arteries and veins is connected to the vessels of the placenta. Then they decrease in diameter and flow into the capillaries of the villi. This place is the point of intersection of the uterine (maternal) and placental (fetal) vessels. It is here that gas exchange is realized between the blood of the expectant mother and the child.

The pathological process in any of these areas leads to hypoxia of the unborn child. Most often, the lesion occurs at the level of the uterine and placental vessels at their junction. Also, fetal hypoxia may be associated with extragenital pathology of the mother, leading to insufficient blood supply.

Classification

Doctors classify fetal hypoxia according to several criteria. According to the time of development of the process, acute and chronic types of pathology are distinguished.

Acute fetal hypoxia develops over a short period of time, from several minutes to several hours. It is usually associated with placental abruption or vascular thrombosis. In the absence of medical care, acute oxygen starvation often ends in intrauterine fetal death.

Chronic fetal hypoxia is a long process that develops over several days or weeks. This type of oxygen starvation usually occurs against the background of concomitant pathology - anemia, preeclampsia, diabetes. Constant hypoxia is the cause of intrauterine growth retardation (hypotrophy) and pathologies of the central nervous system of the unborn child.

Depending on the level of injury, the following types hypoxia:

Hypoxic. Occurs with pathologies of the vessels of the placenta or uterus. Also given type oxygen starvation may be associated with maternal comorbidities.

Hemic. Occurs with pathologies of the fetal blood system, when its red blood cells cannot bind oxygen. The most striking example of this type of hypoxia is hemolytic disease.

Circulatory. The type of oxygen starvation is associated with lesions of the vessels of the umbilical cord or fetus. With this type of pathology, the placental blood supply is not disturbed. Circulatory hypoxia occurs when birth defects fetal heart, as well as when clamping the arteries and veins of the umbilical cord.

Fabric. A rare type of fetal hypoxia associated with metabolic disorders in the body of the unborn child. Typically, tissue oxygen starvation occurs in congenital pathologies of enzyme systems.

Depending on the severity of the course, there is a third classification of fetal hypoxia. The functional or compensated form of oxygen starvation is the easiest, it does not lead to disturbances in the body of the unborn child.

Metabolic or subcompensated form is characterized by metabolic disorders, accumulation harmful products. However, this type of hypoxia is reversible. With the timely provision of medical care, the birth of a completely healthy child is possible.

The destructive or decompensated form is the most severe fetal hypoxia. It is accompanied by irreversible processes in the body of the unborn child, pathologies in the central nervous system and other anatomical structures.

Doctors also distinguish primary hypoxia, which occurs before the 16th week of pregnancy, and secondary, which develops at a later date.

Causes

There are many reasons causing intrauterine hypoxia fetus. The most common of these include the following factors:

Gestational arterial hypertension (late preeclampsia)

This pathology occurs due to improper development of the uteroplacental vessels after 20-22 weeks of pregnancy. To restore blood flow, the woman's body reflexively increases blood pressure. For a while, this measure is effective.

However, with an increase blood pressure there is a spasm of the vessels of the uterus and placenta. Reducing the diameter of the arteries leads to a decrease in blood flow in them and to chronic fetal hypoxia.

To the symptoms late preeclampsia pregnant women include an increase in blood pressure, swelling and the appearance of protein in the urine. Usually, the first signs of arterial hypertension occur after 32 weeks of the gestation period. More early start clinical manifestations talking about severe course pathology.

Premature detachment of a normally located placenta

Premature abruption of the placenta most often occurs during childbirth, but it can be observed throughout the entire period of pregnancy. This pathology is the most common cause acute fetal hypoxia.

The pathogenesis of placental abruption is associated with its improper fixation, structural anomalies, increased emotional or physical stress. Sometimes this disorder occurs with a lack of progesterone. Detachment of more than half of the area of the placenta leads to instant death of the fetus.

Symptoms of placental abruption are uterine bleeding and cramping pains in the lower abdomen. If these signs are present, the expectant mother should immediately seek medical attention. medical care.

Anemia

Anemia is a lack of hemoglobin in a unit of blood. Most often, expectant mothers are prone to the development of an iron deficiency type of this pathology. Less often, anemia occurs against the background of a lack of vitamin B12, folic acid, with bleeding or a disease accompanied by the breakdown of red blood cells (malaria).

The main consequence of anemia is chronic hypoxia fetus. The main symptoms of pathology on the part of the mother include dizziness, nausea, weakness, pallor of the skin, fainting.

Infectious diseases

Viral and bacterial diseases are a risk factor for intrauterine fetal hypoxia. Some infections affect the homeostasis system, causing pathologies of the blood coagulation system. Diseases contribute to the formation of microthrombi that clog the lumen of the uterine and placental vessels.

In the same way infection can cause a state of intoxication, contributing to a decrease in oxygen in the blood. Prolonged high fever is the cause of fetal hypoxia.

Multiple pregnancy

When carrying twins or triplets, the likelihood of intrauterine fetal hypoxia increases significantly. This feature associated with an increase in oxygen demand due to distribution among several fruits.

Fetal movements / when to worry?

Degrees

During ultrasound using a doppler sensor, doctors distinguish three degrees of fetoplacental insufficiency:

Type 1a oxygen starvation of the fetus is accompanied by impaired blood supply in the uteroplacental vessels;
1b type of oxygen starvation of the unborn child is characterized by pathologies of blood flow in the fetal-placental area;
2 degree of fetal hypoxia is characterized by impaired blood flow in both systems, but they are in a state of compensation;
3 degree of oxygen starvation of the fetus is accompanied by a violation in any of these systems, accompanied by a threat to the life of the fetus.

Symptoms

The symptoms of fetal hypoxia are subjective, they cannot speak with absolute certainty about the presence of pathology. That is why expectant mothers should not miss scheduled examinations and consultations with an obstetrician-gynecologist.

Light and average degree fetal hypoxia usually does not manifest itself. In late pregnancy future mother may note a change in the nature of fetal movements. At acute form pathology, the baby begins to move intensively, with a chronic type of hypoxia, its activity can be reduced.

Severe decompensated form of oxygen starvation of the fetus often manifests itself intrauterine delay growth and development of the unborn child. That is why the expectant mother may notice a slow increase in the girth of the abdomen and a lag in the height of the uterine fundus from the gestational age.

For self-diagnosis of fetal hypoxia, the expectant mother can try to listen to his heartbeat with a phonendoscope. This method is possible only after the 20th week of pregnancy. Normal value the pulse of the unborn child lies in the range from 120 to 160 beats per minute.

An increase in heart rate often accompanies acute fetal hypoxia. A pulse less than 120 beats per minute can be observed with chronic oxygen starvation of the unborn child.

Diagnostics

Various instrumental research methods are used to diagnose the condition of the unborn child. The simplest of them is ultrasound. With the help of ultrasound, the doctor can indirectly judge the presence or absence of fetal hypoxia.

Ultrasound equipment allows you to see the structure of the placenta, detect foci of detachment, its aging, and measure the thickness of the organ. Also, specialists can visualize the body of the fetus for the presence of congenital pathologies heart and blood vessels, as well as the correspondence of its size to the gestational age.

Gives a more accurate picture of the state of the fetal blood supply. This method diagnostics is based on the presence of a special sensor that reads information about the direction and speed of fluid flow in the vessels.

Using dopplerometry, doctors can visualize blood flow in all vessels of the uterus, placenta, umbilical cord, and fetus. The instrumental research method allows you to establish the degree of fetal hypoxia and make a prediction about the further course of pregnancy.

Cardiotocography - method instrumental diagnostics fetal condition. CTG allows you to indirectly judge the presence or absence of hypoxia in the unborn child. The principle of operation of this equipment is to register the baby's heart rate in response to stimuli.

In the presence of hypoxia, the rhythm of the heart rate is monotonous, the average pulse is less than 120 or more than 160 beats per minute. Normally, a child should not register decelerations - periods of a decrease in heart rate by 30 or more beats per minute for a period of more than 30 seconds.

Treatment

Treatment of fetal hypoxia depends on the cause that caused it. In the presence of a subcompensated and decompensated form of oxygen starvation of the unborn child, a woman needs hospitalization. Under strict indications, premature delivery is possible.

The main principles of treatment of intrauterine fetal hypoxia is the resumption of normal blood circulation. For this, the expectant mother is introduced medicines, expanding the lumen of blood vessels (, Eufillin). Also, pregnant women are shown taking drugs that improve tissue metabolism ().

In the presence of uterine hypertonicity, the use of myotropic agents is indicated (,). Also, all expectant mothers are recommended the introduction of B vitamins, which improve the rheological properties of blood.

If the expectant mother has a specific disease, she is shown a special therapy aimed at its treatment or compensation. Deficiency anemia should be treated with iron supplements, folic acid and vitamin B12. For the treatment of gestational arterial hypertension, the use of Methyldopa and.

Consequences

Acute fetal hypoxia is a risk factor for intrauterine fetal death. The chronic type of lack of oxygen can cause various consequences. Most often, severe fetal hypoxia is the cause of a delay in the development of its growth and development. It also increases the likelihood of congenital pathologies of the central nervous system. Cells of the brain and spinal cord are most sensitive to oxygen deficiency.

Children suffering from hypoxia during intrauterine life may differ from their peers. This pathology is the cause of mental retardation and mental development, brain diseases. Quite often, after birth, such children are restless, in the future they are difficult to learn.

Prevention

In order to prevent fetal hypoxia, the expectant mother is recommended to healthy lifestyle life. A pregnant woman should exclude smoking and alcohol, emotional stress and hard physical labor. Her diet should include a variety of wholesome foods enriched with all vitamins and minerals.

The basis for the prevention of fetal oxygen starvation is pregnancy planning. Before conceiving a future mother, it is recommended to compensate for all chronic pathologies get tested for sexually transmitted diseases.

Hypoxia during childbirth

Fetal asphyxia- an acute state of lack of oxygen during childbirth with the preservation of cardiac activity, this term is synonymous with hypoxia. Usually, the pathology occurs due to a violation of uterine contractions, trauma, clinical narrow pelvis. Fetal hypoxia during childbirth can also be caused by the misuse of medications.

Fetal hypoxia at birth is diagnosed using the CTG apparatus. Its consequences are possible complications on the central nervous system and in potential fetal death. To treat oxygen starvation of the unborn child, contractions should be normalized or an emergency caesarean section should be performed.

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 fetal development. 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. It causes the syndrome chronic fatigue, 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- 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.

For oxygen transfer to be fast and efficient, inner surface the alveoli are 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. Resins in tobacco smoke clog the alveoli and disrupt the synthesis of pulmonary 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 placenta, increased tone uterus, overgrowth and other deviations from normal course 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. He can call 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 - the vital 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, capriciousness.

In the later stages, it can cause serious disorders in the central nervous system of the baby: epilepsy, damage to the cranial nerves, mental development disorders, 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 active fetal movements are 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 amniotic fluid for analysis. 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. 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 of them - a healthy lifestyle, frequent walks in the fresh air, a balanced diet, reasonable physical activity 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.

Intrauterine fetal hypoxia is called oxygen starvation of the fetus in the womb. This state is not independent disease rather, it is a consequence of various pathological processes in the body of the mother, fetus or placenta.

How does intrauterine fetal hypoxia manifest itself?

If the oxygen starvation of the fetus has just begun, then the expectant mother may note restless behavior and increased fetal movement. Moreover, these manifestations will be intense, but any connection between physical activity And active movements there will be no fruit.

Unfortunately, many expectant mothers rarely seek qualified medical help when they are too high activity fetus, but oxygen starvation at the same time continues to progress - the second phase begins. It will be characterized by a decrease in the motor activity of the fetus, a decrease in the frequency and strength of tremors. If a woman notes that the fetal movement has decreased to 3 times per hour, then this is already a reason to see a doctor.

When examining a pregnant woman with suspected intrauterine fetal hypoxia, the doctor will note an increase in the heart rate of the latter up to 160 beats per minute, muffled heart sounds and a decrease in heart rate to 100-120 beats per minute.

Classification of intrauterine fetal hypoxia

The considered state can proceed in three different forms, the differentiation of which depends on the rate of progression of the pathological process:

lightning fast;
acute - as a rule, develops during childbirth and has a duration of several minutes or hours;
subacute - develops shortly before childbirth (1-2 days);
chronic - is characteristic of toxicosis, infection of the fetus, prolonged pregnancy, incompatibility of the blood of the mother and fetus.

Reasons for the development of intrauterine fetal hypoxia

In principle, any pathological processes occurring not only in the body of the unborn child, but also in a woman. Doctors identify only a few causes that are most often detected during the examination of a pregnant woman.:

placental insufficiency. insufficient supply of oxygen and nutrients the fetus occurs due to circulatory disorders in the mother/placenta/fetus system.
Rupture of the uterus.
Anemia, cardiovascular diseases mother.
Premature detachment of a normally located placenta.
Heavy late toxicosis(gestosis).
Weakness of labor activity or its discoordination (anomalies of labor activity).
Entanglement of the umbilical cord.
Intrauterine infection of the fetus.
Prolonged squeezing of the head during childbirth.
Congenital fetal malformations.
Partial or complete overlap of the uterine os by the placenta is placenta previa.
Intoxication of the mother's body.
Pregnancy reversal.

Diagnostic measures

To determine the very fact of the presence of fetal oxygen starvation and to understand the extent to which this pathology occurs, doctors carry out a whole complex diagnostic measures. As part of these surveys, women are given:

Cardiotocography

It makes it possible to register contractions of the heart of the future baby, in addition, the specialist will evaluate the motor activity of the fetus. For a healthy fetus, the following signs of heartbeats will be characteristic:

heart rate fluctuates between 120-160 beats per minute;
the frequency of contractions increases as a response to the movement of the fetus or a sharp change in the position of the body of a pregnant woman;
complete absence of heart rate slowdowns.

With oxygen starvation of the fetus, a specialist will identify:

a significant violation of the rhythm of the heartbeat - it will be either increased or slowed down;
the complete absence of an increase in heart rate in response to movements or contractions - a monotonous rhythm;
rhythm slowdowns, which will be frequent and deep.

Doppler ultrasound

When the doctor can determine the state of blood circulation in the mother / placenta / fetus for a period of more than 20 weeks of pregnancy. If research is done uterine arteries, then it will be possible to detect violations of the uteroplacental blood flow at the earliest stage of development, which will prevent the progression of severe fetal hypoxia.

As additional results, doctors determine the structure of the placenta and the level of amniotic fluid.

Counting fetal movements

It is worth mentioning right away that this particular diagnostic method is inaccurate, therefore it is used only for low-risk pregnant women, that is, the expectant mother does not have chronic diseases or there are no malformations of the unborn child. Such an examination makes it possible to detect hypoxia at the first stages of progression, which is determined by a change in the motor activity of the fetus.

You can conduct a similar test without visiting a doctor. The woman should lie on her side in a position that is comfortable for her and concentrate on the movements of the child. If within 60 minutes the expectant mother feels less than 10 movements, then it is necessary to seek qualified medical help.

Important: such a test can be performed after the 25th week of pregnancy.

The alternative is test D. Pearson "Count to ten". It is used from the 28th week of pregnancy. Movements are counted from 9 am to 9 pm. The time of the 10th perturbation must be recorded. If there is little movement, you should inform your doctor.

Possible consequences of intrauterine fetal hypoxia

Why do doctors insist that a woman, even with dubious assumptions about pregnancy disorders, seek medical help? The fact is that even mild intrauterine fetal hypoxia can lead to the development of very unpleasant consequences.

If acute fetal hypoxia is diagnosed, then the consequences of this condition may be:

In the presence of chronic intrauterine fetal hypoxia, the consequences may be as follows:

at birth, the baby will short stature and critically low weight;
anemia of the newborn;
high susceptibility to infectious diseases;
attention deficit disorder in older children;
insufficient temperature regulation of the body in the newborn age.

Most of the consequences are associated with cerebral hypoxia and premature birth, because in order to save the baby's life, doctors carry out an emergency delivery much earlier than the due date.

Note:according to statistics, if a child diagnosed with intrauterine hypoxia successfully survived the first month after birth, then the considered pathological condition has no consequences.

Treatment of intrauterine fetal hypoxia

The choice of tactics for the treatment of the pathological condition under consideration depends on the state of health of the mother, the duration of pregnancy, the presence of concomitant diseases from the expectant mother. Since the causes of the development of intrauterine hypoxia are varied, there is no single principle for its treatment - everything is done in strict individually. If the state of health of both the woman and the fetus allows, then the doctor may apply conservative methods treatment of intrauterine fetal hypoxia:

Note:in medicine there is no medicinal product who is able to heal placental insufficiency. All of the above methods contribute to getting rid of factors provoking intrauterine fetal hypoxia. If a violation of placental blood flow is diagnosed, then doctors only observe the unborn child in order to carry out an emergency delivery on time. The more the fetus lags behind in development from the norm, the earlier it is necessary to carry out emergency delivery.

Intrauterine fetal hypoxia is a pathological condition that can lead to serious consequences. It is almost impossible to make any predictions about the likelihood of developing the condition in question, so women who are at the stage of pregnancy planning should not only go through full examination from specialized specialists, but also to give up bad habits.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category