How to test for hypoxia. Among these diseases can be identified. Fetal hypoxia: types

Hypoxia: intrauterine, during childbirth and chronic - causes, signs, consequences, treatment

The term "hypoxia" means an abnormal state of the body, which develops when the enrichment of tissues and cells of the body with oxygen stops, as well as under adverse factors in which oxygen is not absorbed by the tissues. Hypoxia of the brain is a whole chain of circumstances and responses of the body that occurs when the incoming volume of oxygen does not correspond to the needs of the brain cells in it, leading to oxygen starvation of the brain. The state of hypoxia occurs in adults, as well as children, and an unborn baby is also capable of experiencing a lack of oxygen.

Hypoxia of the fetus and newborn

Fetal hypoxia is very dangerous state, the reasons for which it develops may be different, but it always leads to serious consequences, which are directly dependent on the time of its occurrence. On initial term pregnancy, this can cause a slowdown in the development and pathology of the fetus, in the later stages it can cause significant disturbances in the central nervous system. With placental abruption, acute hypoxia develops, from which the baby may die. Intrauterine hypoxia also leads to delays in the development of the fetus, to difficulties in adapting the child to postpartum period and various neurological disorders: restless sleep, poor appetite, whims, convulsions.

These complications are due to the fact that the body of the unborn child during hypoxia triggers the action of mechanisms aimed at increased blood supply to vital organs - the heart, adrenal glands, brain tissues, and in gastrointestinal tract, kidneys, lungs, and in the skin, the strength of blood flow decreases. Therefore, a child diagnosed with "Intrauterine hypoxia" can be born with possible violations the functions of these organs. This manifests itself in the form of respiratory disorders, fluid retention in the body, and frequent regurgitation. The next stage, which is characterized by the appearance of signs of oxygen starvation and nervous exhaustion, occurs if oxygen starvation proceeds for a long time. In this condition, the heart rate slows down, the tone drops blood vessels, swelling of body tissues occurs, while the brain suffers, nerve cells die, others are vital important organs are unable to perform their functions and further there is a danger to the life of the child. During the period of gestation, the fetus receives through the placenta all the substances and trace elements necessary to maintain vital activity through it, oxygen enters from the mother's blood into the tissues of the fetus. If a pregnant woman suffers from a lack of nutrients, the fetus will also experience inconvenience.

Video: about fetal hypoxia

Causes and classification of hypoxia

Fetal hypoxia differs in its characteristics, severity of manifestations, the mechanism of its development and the extent of exposure. There are three main types of hypoxia:

1. Acute hypoxia may occur with complicated childbirth;
2. Subacute develops 1-2 days before the birth process;
3. Chronic hypoxia progresses during the period of childbearing gradually over a long period of time.

This condition can be provoked by some systemic diseases of a pregnant woman, which include the following reasons:

• Iron deficiency, when it disrupts the transport of oxygen cells to the tissues of the body;
• Diseases of cardio-vascular system causing, in particular, a deterioration in the blood supply to the fetus;
• Pathologies of internal organs (pyelonephritis, diseases of the urinary system);
• Chronic respiratory diseases such as bronchial asthma, asthmatic bronchitis;
• Deviations in work endocrine system- diabetes.

Great importance in the development chronic hypoxia have a child bad habits of expectant mother . A pregnant woman should never drink alcohol or smoke. All toxins, like useful material, enter the blood of the baby and cause negative consequences.

Other good reasons for the development of hypoxia in a child may be possible anomalies in the development of the placenta, postmaturity during pregnancy or increased tone uterus, other deviations from the normal natural algorithm of bearing a child, the most frequent and dangerous factor for acute intrauterine hypoxia, premature detachment of a normally located placenta may be. Fetal hypoxia can also be caused by infection of the fetus in the womb, malformations in its development, incompatibility of the fetal blood with the mother's blood - this condition causes, it is equally dangerous for the unborn child and the woman herself. In severe childbirth, hypoxia of the brain of the newborn may occur, caused by a mechanical factor - prolonged squeezing of the head in the birth canal, entanglement around the neck of the umbilical cord, as well as mucus and amniotic fluid. This complication of childbirth is called asphyxia and requires resuscitation. combination of acute and chronic forms hypoxia is the most unfavorable in predicting the development of complications in a baby at birth.

How is intrauterine hypoxia determined?

The first symptom of fetal hypoxia is active movements child, with this, the baby reflexively tries to increase blood supply, increase blood flow. At first, a woman notes strong and sharp points, violent stirring, it can cause her inconvenience and even pain. If fetal hypoxia increases, its tremors gradually weaken, and may disappear altogether. This sign should alert the woman, let her know that not everything is in order with the baby. IN antenatal clinic It is recommended that at a gestational age of more than 28 weeks, keep records of fetal activity.

It is considered normal when a child moves at least 10 times in 12 hours, if there are fewer of them, you need to urgently seek medical help.

When determining intrauterine fetal hypoxia, obstetricians use complex methods designed to assess the condition of the fetus. These methods include listening to fetal heart sounds using an obstetric device - a stethoscope. The doctor evaluates the heart rate, their tone, rhythm, extraneous noise. But this method cannot be accurate enough, therefore, at the slightest suspicion of hypoxia, cardiotocography should be additionally applied, using a special ultrasonic sensor, in this study, the indicators are recorded on paper and the doctor is able to analyze the fetal heart rate in different parameters. Another method that allows you to explore to determine the deviations in the blood flow between a woman and the fetus is called. Here, blood circulation is assessed in all links of the fetal blood supply chain, the severity of hypoxia and the prognosis for the course of pregnancy depend on the nature of the changes. In addition to the manipulations described, the fetal ECG also provides information about the state of his health, and laboratory tests of the mother's blood for the biochemical composition and levels of pregnancy hormones are also used.

In addition, if there is a suspicion of intrauterine hypoxia, amniotic fluid is analyzed for the presence of meconium, the original feces, in them. Lack of O 2 provokes relaxation of the muscles of the rectum of the baby and meconium enters the amniotic fluid. This method of diagnosis is especially important with increasing labor activity, the whole tactics of conducting birth process.

Treatment and prevention of intrauterine form

If the doctor suggests intrauterine fetal hypoxia, the woman is sent to the hospital for additional examinations and necessary therapy. When the condition of the fetus allows, treatment at home under medical supervision is possible. A prerequisite for the cure of hypoxia is the complete rest of the woman. Treatment for intrauterine hypoxia should be aimed at ensuring normal blood supply to the fetus, it will depend on the cause of hypoxia and the degree of pathology detected. In most cases, the expectant mother is prescribed strict bed rest, drugs are prescribed that reduce blood viscosity, improve blood supply to the placenta and normalize the metabolism between mother and fetus, the predominant position in bed is on the left side. If during the course of the treatment no positive changes are noted, and fetal hypoxia continues to increase, obstetricians may decide to perform an operation. caesarean section when the period exceeds 28 weeks of pregnancy. To prevent such complications future mom should give up bad habits, spend more time outdoors, not overwork, lead healthy lifestyle life. Great importance should be given to prevention iron deficiency anemia as one of the main causes of fetal hypoxia. Complete balanced diet, registration for pregnancy in the antenatal clinic in the early stages and timely visits to the doctor will play a huge role in the prevention of fetal hypoxia and its complications. If a pregnant woman was diagnosed with Chronic intrauterine hypoxia, mandatory cardiomotor monitoring of the fetal condition is carried out during childbirth in order to minimize negative consequences for the child.

How is hypoxia of already born children treated?

Immediately after birth, when assessing the state of health of the child, the Apgar scale is used, according to which the condition is assessed. skin, reflex excitability and muscle tone. Normally, the indicator should be from eight to ten points, a score below five points means hypoxia, the lower the number of points assigned, the more difficult the child's condition.

Table of Apgar score criteria:

(click to enlarge)

With severe hypoxia, the child is pale, muscle tone is reduced, convulsive syndrome, deviations in the functioning of internal organs, up to serious violations CNS with the formation of blood clots and. At birth, a child with suspected hypoxia should immediately receive medical care aimed at relieving oxygen starvation: the airways are freed from fluid and mucus, warm the child, carry out resuscitation measures if necessary, achieving improvement to a state that does not pose a threat to life. After stabilization of the baby's condition, they are placed in a pressure chamber, nutrient solutions are injected, and therapy is carried out aimed at removing the manifestations of hypoxia. In the first month of life, the baby after undergoing hypoxia is restless, easily excitable, muscle tone elevated, which manifests itself in involuntary twitching of the arms, legs, chin, are possible. In other cases, lethargy, unwillingness to breastfeed, he is disturbed frequent regurgitation. The older the baby becomes, the less noticeable these manifestations are, however, at 5-6 months, the initial symptoms may return: convulsions may occur again, muscle tone may increase. This period can last for several months or several years, it will depend on the degree of damage to the brain of the baby and his ability to recover. The consequences of hypoxia of the brain of the fetus and newborn are very serious, up to the death of the baby Therefore, it is very important to identify this condition in time and take measures to prevent complications in the child's health in the future.

Measures to restore the health of the child

Further a baby who has undergone intrauterine hypoxia should be constantly registered with a neurologist so that the doctor has the opportunity to notice pathologies in time in the physical and mental development and appoint necessary therapy, since the state of prolonged oxygen starvation can cause various deviations and lags in the development of the baby. To avoid this, it will be necessary to regularly assess his health and carry out appropriate treatment if necessary. To help a newborn baby cope with the effects of hypoxia, parents should provide calm atmosphere at home, comfortable temperature regime, protect from overheating and hypothermia. You should not swaddle the child tightly, you need to give him the opportunity to move more. The big plus is breast-feeding, warm baths with soothing herbs, special massage and gymnastics, which can be applied pediatrician I have to teach my mother. This should be done daily for 2-3 years.
In difficult cases of the course of the disease, as prescribed by the pediatrician, massage should be carried out by a specialist who has the skills to treat diseases of the nervous system. It is with the help of massage that you can help restore the nervous system and overcome delays in the development of the child. Reflexology has an intense effect on the central nervous system, it is also used as directed by a doctor if hypoxia has caused significant disturbances in the development of the child. Eat various methods reflexology: acupuncture, laser treatment, etc. If indicated, it is advisable to consult with an osteopath discuss with him the feasibility of osteopathic treatment. Help in overcoming the consequences of intrauterine hypoxia can and physiotherapy, this becomes relevant with a delay in the development of motor skills. It should be carried out by a specialist who owns these skills. If there are delays speech development you need to see a speech pathologist. All of the above activities should be carried out in a strict system, with a certain sequence and under the obligatory supervision of the attending physician, who is able to track the dynamics of the mental and physical development of the child. Self-medication is absolutely unacceptable! With the right and responsible approach to treatment, in most cases it is possible to overcome the negative residual effects of hypoxia and return the child's condition to normal.

Prognosis and consequences of hypoxia in children

With proper treatment during the first year of life, the child's health should return to normal, but in some cases the consequences of hypoxia can appear even after a rather long period of time. Children may have a delay in speech development, inability to concentrate, restlessness, constant headaches. In the most difficult cases, it is possible to develop progressive CNS lesions, such as a significant impairment of hearing, attention, as well as persistent disorders of the central nervous system, such as epilepsy, other disorders. cerebral circulation including (in rare cases) cerebral venous.

Consequences of hypoxia: stroke (left) and hypoxic-ischemic encephalopathy (right) in a newborn

Hypoxia in adults: causes and consequences

Not only newborn children can suffer from hypoxia, adults also experience oxygen starvation, the causes of which can be different. As a rule, this condition is caused by chronic diseases.

Hypoxia in adults also leads to disturbances in the work of the central nervous system, syndrome chronic fatigue, reduced immunity, sleep disturbances, general deterioration of health. Various methods are used to treat hypoxia in adults, first of all, it is necessary to treat the underlying disease that caused it.

Video: about chronic hypoxia at the seminar

Oxygen cocktail for chronic fatigue

The use of oxygen cocktails can help to cope with the consequences of hypoxia and improve the quality of life. This invention allows you to restore strength during overwork, saturate cells with oxygen, improve metabolism, increase concentration, attention and reaction, and also has many more positive qualities. An oxygen cocktail is a thick foam that is completely filled with oxygen molecules. It is prepared on juices, fruit drinks, syrups and enriched with oxygen using special devices, oxygen concentrators. For a long time oxygen cocktails were available only in medical institutions, but in Lately compact oxygen cartridges appeared on sale, this allows you to cook healthy drink Houses. Chronic oxygen starvation of the brain in adults also leads to negative consequences, destruction of nerve endings and. To prevent this and maintain the quality of life, you should be observed by doctors, monitor your well-being and systematically treat chronic diseases. Postpone the onset of old age and maintain vigor for long years quite within the power of all who sincerely desire it. To do this, you need very little - to lead a healthy lifestyle, spend more time in the fresh air, relax and value yourself and your health.

Video: prevention of hypoxia

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

Waiting for a miracle

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

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

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

What is hypoxia

"Hypoxia" is an ancient Greek word that literally translates as "low oxygen". This term refers to the oxygen starvation experienced by the body or its individual organs due to the influence of certain factors.

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

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

Symptoms of fetal hypoxia

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

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

The first thing to pay attention to is the activity of the fetus. The norm is about ten movements per day. In the initial stages of hypoxia, the baby begins to feel discomfort, so it is overly active. With more prolonged lack oxygen, the number of perturbations decreases. In addition, intrauterine hypoxia can be characterized by frequent fetal hiccups.

If the deviation of the number of perturbations from the norm and frequent hiccups not related to physical activity expectant mother or being in an uncomfortable position, is required in as soon as possible contact a specialist who will identify the cause of this behavior of the fetus and, if necessary, prescribe treatment.

Causes

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

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

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

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

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

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

Types of fetal hypoxia

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

The degree of progression of oxygen starvation

Three degrees of development of fetal hypoxia have been identified. Initially, the fetus, not having received the required amount of oxygen, tries to compensate for its lack. The first degree is compensation for the lack of oxygen. In the body of the baby, changes begin to occur, aimed at increasing the volume of incoming oxygen. The level of a hormone that increases the tone of blood vessels, cortisol, is rising. Enhanced Level cortisol stimulates an increase in the volume of blood that circulates through the vessels, and an increase in heart rate. The composition of the blood changes: the level of hemoglobin and red blood cells increases. In addition, it is noted increased activity baby. He begins to move more intensively and make respiratory movements, despite the closed glottis.

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

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

Diagnostic measures

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

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

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

Treatment

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

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

With positive dynamics, the patient is discharged and given recommendations for the prevention of hypoxia. These include outdoor walks, reduced physical activity, giving up bad habits and keeping certain rules in nutrition. If the treatment was ineffective, and oxygen deficiency persists, surgical removal of the fetus is required. If the gestational age exceeds twenty-eight weeks, the doctor prescribes an operation - a caesarean section.

Prevention

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

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

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

Consequences

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

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

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

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

While in the womb, the baby cannot breathe on its own, as its lungs will only expand after birth. Oxygen is essential for the body to full development and further functioning of its organs.

This vital substance of the child during pregnancy is provided by the placenta, which is enriched with oxygen from the mother's blood. If this transportation is disturbed, fetal hypoxia begins during pregnancy - oxygen starvation of a small organism. The disease is quite common, but dangerous if no measures are taken.

It is possible to restore and improve the condition of the fetus during hypoxia only if it is recognized in time.

• Symptoms in the early stages

The difficulty is that in the early stages of pregnancy, it is not detected. The doctor can only assume this disease if the mother is diagnosed. That's why initial signs fetal hypoxia is determined only on special equipment for examinations. In particular, ultrasound and Doppler are used for this purpose (a method for detecting a heartbeat in a fetus).

• Self-diagnosis

Many mothers, worrying about the condition of their baby, want to know how to determine fetal hypoxia on their own and at what time it can be done. This becomes possible only at the 18th week or even later, when the baby's movements are felt. A woman should be observant during this period and notice how and when the baby usually moves. The first sign of hypoxia is a decrease in its activity, movements become rare, lethargic, barely noticeable. If such a symptom is present, it is necessary to tell the doctor who is observing you about it.

• Laboratory diagnostics

A decrease in the activity of the child in the womb may be a sign of other abnormalities in its development. To confirm or refute the diagnosis, an additional examination is required, which can detect more than clear signs fetal hypoxia.

1. Ultrasound: the physical data do not correspond to the norm (weight and size are smaller), there is a developmental delay, premature maturation of the placenta, the presence of too thin or too thick walls;
2. Dopplerometry: blood flow disturbances in the uterine arteries and placenta, bradycardia (low heart rate).
3. Cardiotocography (indicated in the documents as CTG and performed only after the 30th week) often gives incorrect results, therefore, to confirm the data, it is done several times.
4. Sometimes amnioscopy is used, which reveals the state of the amniotic fluid, which gives sufficiently reliable data on whether it is possible to speak of hypoxia in this or that case: in the presence of this disease, they become cloudy.

For greater confidence in the diagnosis of a pregnant woman, a number of blood tests can be prescribed - hormonal and biochemical. If they find a high concentration of enzymes, fat oxidation products, such results will also indicate a disease.

Treatment of intrauterine hypoxia

Timely diagnosis and the lack of indications for an immediate caesarean section (in which cases it is done, read) will allow for the treatment of hypoxia during pregnancy in order to reduce the risk of the baby getting sick after birth.

For this, a whole range of activities is carried out:

1. Establish the cause of the development of oxygen starvation of the fetus.
2. Remove it immediately if possible. If it is a matter of a woman's failure to comply with elementary recommendations during pregnancy, they explain to her how this all can end. Regular walks, good nutrition, proper sleep, the absence of bad habits can save the baby from this problem. If some disease of the mother became the cause and its treatment is possible in this position, all possible measures to get rid of it.
3. If necessary, bed rest is prescribed, which helps to improve the blood supply to the uterus.
4. Medicines are prescribed: no-shpu, brikanil, suppositories with papaverine, ginipral (they reduce uterine contractility); reopoliglyukin, aspirin, chimes (restore blood circulation); Essentiale Forte, Lipostabil (improve cell permeability to oxygen); , glutamic and ascorbic acids, glucose solution (to restore impaired metabolism);
5. It is recommended to drink water enriched with oxygen.

Sometimes even complex therapy with fetal hypoxia is ineffective. And if the fetus has already reached viability, the doctors decide to carry out an emergency delivery. In order not to lead to such an outcome and not risk the health of your own baby, it is better to warn him in advance with preventive measures.

Prevention

Effective prevention hypoxia during pregnancy includes a whole range of measures that will help to avoid the disease and its consequences. The expectant mother should lead a healthy lifestyle:

• get rid of bad habits;
• spend a lot of time in fresh, clean air (preferably away from chemical plants and highways);
• visit a doctor regularly;
• keep your doctor informed of all your past and present illnesses;
• eat right, including iron-rich foods in your diet;
• master breathing exercises;
• fully rest;
• sleep at least 8-9 hours a day;
• do not overwork;
• avoid stress and nervous experiences.

All these recommendations on how to avoid fetal hypoxia during pregnancy are very important to follow for absolutely all women, regardless of whether they are at risk or not. By observing them, you can endure strong baby without any developmental delays. If you take it lightly, dangerous consequences cannot be avoided.

Dangerous consequences of hypoxia during pregnancy

Consequences different forms oxygen starvation of the fetus may not be the same.

Chronic hypoxia

Untimely diagnosis and lack of treatment of pathology leads to prolonged oxygen starvation, which is called chronic fetal hypoxia. The consequences are the saddest picture:

• the formation of fetal organs is disrupted;
• deviations in the development of the embryo;
• damage to the central nervous system;
• growth retardation (violation of physical development);
• poor adaptation of the child to life outside the womb.

Newborns with chronic hypoxia will have poor appetite, he will be restless, the autonomic nervous system will be severely damaged.

Acute hypoxia

Acute fetal hypoxia is not conducive to therapeutic intervention. If the child is already viable, an emergency operation is performed to extract the fetus. If this is not done in time, prolonged oxygen starvation will lead to the death of brain cells and to (breathing disorders).

A pregnant woman should take care of both the baby and herself, since his condition also depends on the state of her health, diet and diet. Want to endure, give birth and grow healthy strong man- then save him from intrauterine oxygen starvation.

When a pregnant woman hears the diagnosis of "fetal hypoxia", then she begins to become hysterical and panic. But the point is not at all that this is such a terrible disease, but that not every patient understands what this diagnosis means, and not every doctor can fully explain. In addition, domestic medicine today prefers the treatment of the disease, rather than the elimination of the problem, in which the financial side plays a significant role.

What is "fetal hypoxia" and when does it occur?

Fetal hypoxia, according to official sources, including medical encyclopedia, this is a lack of oxygen in the body of the fetus, which leads to significant changes. It is known that the blood of the mother, which enters the unborn child through the placenta, contains oxygen that saturates the fetus. If this oxygen is absent or lacking, then it is dangerous for the children's cardiovascular and nervous system.

It should be remembered that the disease can occur both in the early stages of the disease, and in the later ones. Lack of oxygen for a long time can seriously affect mental and physical development child. In addition, not every pregnant woman, feeling discomfort inside herself, goes to the doctor for an examination. In order to avoid consequences, treatment and elimination of the disease should begin before the seventh day of oxygen starvation by the fetus.

So, the manifestation of hypoxia in the first 2-3 months of pregnancy entails the problem of the development of the main brain in a child. The manifestation of hypoxia after 20 weeks of fetal life can provoke the following diseases:

• intrauterine growth retardation;
• the problem of the development of the nervous system;
• slowing down the ability to adapt in a born child.

Only 4% of women suffering from fetal hypoxia give birth to healthy children. But this, again, is not a reason to panic if the presence of a disease is determined in time (this is not even a disease, but the consequences of the mother's lifestyle or genetic conditioning).

Reasons for the development of hypoxia

Fetal hypoxia, the causes of which have several sources, is mainly acquired, and only in some cases hereditary (although many doctors attribute it to a genetic problem).

The causes of hypoxia may be maternal diseases that occurred before pregnancy or on time:

• diseases or intoxication (nephropathy) of the kidneys;
• pathology of lung development;
• heart failure;
• anemia;
• diabetes.

There is another reason that is not a disease - this is unfavourable conditions work for a pregnant woman where she is at risk of clogging respiratory tract or shortness of breath.

Also, it can be complications during pregnancy itself:

• The main and most common cause of hypoxia is a large number of amniotic fluid;
• preeclampsia;
• pelvic presentation of the fetus;
• placenta disease;
• the presence of more than one fetus;
• failures in the uteroplacental blood flow.

The reason may be in the diseases of the fetus itself:

• anemia;
• congenital defect;
• strong incompatibility of the blood of the child and the blood of the mother;
• infection.

In addition to this type of hypoxia, which occurs during pregnancy, there is also the concept of "acute birth hypoxia", and it manifests itself during childbirth. It can be caused by placental abruption, squeezing of the head by the woman in labor, anesthesia of the birth process, rapid delivery. Acute fetal hypoxia, the consequences of which can cause nervous system disorders or fetal asphyxia, should be prevented by caesarean section (if the first stage of labor), or by forceps (when the uterus is already opened).

Fetal hypoxia: symptoms

The main symptom of fetal hypoxia is the uneven heartbeat of the child. The norm of the heartbeat of an unborn baby becomes 120-160 beats per minute. Minor deviations in one direction or another are not dangerous, but constant jumps from 160 beats to 100-90 beats and back, this may be a sign of hypoxia. Also, a sign of hypoxia will be considered a fetal heartbeat below 70 beats per minute. This can be tracked on Doppler, cardiotocography and other studies.

But how to track that this is a possible fetal hypoxia, according to symptoms at home?

It's all about the movements of the child. If within an hour (during the day) he moved less than 3 times (and this repeats constantly), or at first very active, and then stops moving, this is a signal that you should consult a doctor.

How is fetal hypoxia treated?

There are two options for resolving the disease:

1. Complete the necessary course of treatment. It includes, in addition to taking medications, also drinking water saturated with oxygen (Water Q), cooking food on it.
2. Some doctors do not try to eliminate the disease, but only monitor the child's heartbeat (often this is done with chronic hypoxia). In the event of a threat, call artificial childbirth. It doesn't save the child.

In the treatment of fetal hypoxia, the discipline of the mother is also important. In addition to the course of treatment, there should be complete rest, bed rest, calmness, mood for a normal birth.

How to prevent hypoxia

To prevent the manifestation of hypoxia, a woman can do aqua gymnastics and exercise constant breathing exercises. Of course, before you start doing this, you should consult with your doctor and get his approval.
A pregnant woman should rest a lot and try not to overeat. This is also important, because being overweight produces shortness of breath. You should not follow the rules that a pregnant woman should eat for two. It is enough to increase the number of calories per day by 200-300 at 1200 normal calories, that is, do not eat more than 1500-1600 calories per day.

Regular follow-up with a doctor is also important (at least once a month, although twice is better).

And most importantly: do not panic, because the mood of the mother is reflected in the fetus with a double return.

Fetal hypoxia (oxygen starvation) is a pathological condition during pregnancy that occurs as a result of insufficient oxygen supply to body tissues, or in violation of oxygen absorption by tissues. Hypoxia occurs both during gestation and during childbirth.

10% of pregnancies and births are accompanied by intrauterine hypoxia fetus. Medicine has studied this pathology, is able to detect and eliminate hypoxia, but, unfortunately, the number of cases of pathology does not decrease. Obstetricians rank this pathological condition as a serious cause of morbidity and mortality. babies born and newborns in the first week of life.

Fetal hypoxia during pregnancy develops slowly with a lack of oxygen in the body, or rapidly if the placenta is depleted. Pathology is conditionally divided into two types - acute and chronic fetal hypoxia.

Fetal hypoxia is not a separate disease, but a condition caused by a complex of changes in the body of a woman or an unborn child, which lead to oxygen deficiency and the development of adverse consequences.

Signs and symptoms of fetal hypoxia

The appearance of signs of fetal hypoxia occurs in the second half of the woman's pregnancy, when the child begins to move in the womb.

If the pathology develops on early stage then no symptoms may appear. At this time, mom will feel fine. On late term pregnancy, pay attention to fetal mobility. You can recognize hypoxia by fixing the frequency of the child's movements. Ten times a day, the child begins to move in the womb for several minutes, and then calms down for 1-2 hours. Decreased mobility is a symptom of poor oxygen supply to the body. With an exacerbation of oxygen deficiency, the baby in the womb may not move, as the body's cells are depleted.

In the second half of the pregnancy period, the baby's heartbeat is heard through abdominal cavity using an obstetric stethoscope. If routine examinations are carried out regularly, then the doctor is able to identify the symptoms of fetal hypoxia at an early stage and prescribe necessary treatment. Signs of initial fetal hypoxia include:

• tachycardia (over 160 beats per minute) or bradycardia (below 120 beats per minute);
• decreased heart rate variability;
• monotonous rhythm;
• weakening of the response to functional tests;
• late decelerations.

Another indirect symptom of fetal hypoxia: if a pregnant woman begins to exfoliate the placenta too early. premature maturation also applies to such symptoms.

Pathological symptoms in a woman appear at 35-36 weeks of pregnancy. These include:

• depression;
• frequent insomnia;
• fatigue;
• fatigue;
• frequent nausea.

After 36 weeks, disturbed pressure is often manifested, as well as problems with the organs of hearing and vision.

If hypoxia persists after 35-36 weeks of pregnancy, the pathology becomes chronic.

Acute and chronic fetal hypoxia

If hypoxia develops gradually, then we are talking O chronic insufficiency oxygen. Chronic fetal hypoxia appears only when carrying a child.

Sometimes, the lack of oxygen happens suddenly. This condition is characteristic of childbirth and is called acute fetal hypoxia. Acute hypoxia occurs due to:

• protracted childbirth;
• weak generic activity;
• uterine rupture;
• premature detachment of the placenta;
• entwining the child with the umbilical cord or the formation of knots on the umbilical cord;
• wrong presentation.

Acute fetal hypoxia is extremely dangerous: brain cells quickly die in the absence of oxygen supply.

Causes of fetal hypoxia

The causes of fetal hypoxia are divided into three groups.

Pathological conditions that are not associated with pregnancy and childbirth

1. cardiovascular diseases:
   • heart defects;
   • hypertonic disease.
2. respiratory diseases:
   • Chronical bronchitis;
   • emphysema;
   • bronchial asthma.
3. kidney disease:
   • chronic renal failure;
   • amyloidosis.
4. metabolic disease:
   • diabetes.
5. diseases that occur:
   • extensive blood loss;
   • severe intoxication;

Violation of the fetal-placental blood flow

This group includes pathological conditions directly related to pregnancy, which, to one degree or another, are capable of causing impaired blood flow:

• early and late gestosis;
• the threat of premature birth;
• premature detachment of a normally located placenta;
• prolongation of pregnancy;
• abnormal attachment of the placenta;
• multiple pregnancy.

Fetal diseases

• hemolytic disease, which develops as a result of the Rh conflict between the mother and the fetus;
• congenital malformations;
• intrauterine infections;
• pathology of the development of the umbilical cord;
• protracted birth.

Consequences of fetal hypoxia

Depending on the degree of oxygen starvation before and during childbirth, the consequences for the baby vary.

The prognosis of complications is determined according to the assessment of the condition of the newborn child according to the Apgar scale. If immediately after birth the child's condition was assessed at 4-6 points, and at the 5th minute - 8-10, then the consequences - moderate. If the Apgar scores are lower - severe consequences. And this means:

• neurological disorders;
• hyperactivity;
• retardation of mental or physical development;
• mental and speech pathologies.

In the case of diagnosing hypoxia in a child after birth, the help of a neurologist will be needed, and in the future - child psychologist and a speech therapist.

Treatment of fetal hypoxia

Timely detection of hypoxia, combined with the lack of recommendations for an emergency caesarean section, makes it possible to treat the disease during pregnancy in order to reduce the likelihood of the child becoming ill after birth.

Drug treatment of hypoxia involves the appointment of the following drugs:

1. drugs that reduce uterine contractility:
   • no-shpa;
   • bricanil;
   • ginipral;
   • candles with papaveril.
2. drugs that restore blood circulation:
   • chimes;
   • aspirin.
3. drugs that improve cell permeability to oxygen:
   • lipostabil;
   • Essentiale Forte.
4. drugs that restore metabolism:
   • glucose;
   • vitamin E;
   • ascorbic, glutamic acid.

Treatment aimed at increasing fetal oxygenation, improving uteroplacental circulation and normalization metabolic processes fetus, is carried out in a hospital or on an outpatient basis.

Treatment for fetal hypoxia includes:

• UV irradiation;
• inductothermy or diathermy of the perirenal region;
• intravenous infusions of glucose with cocarboxylase and ascorbic acid;
• oxygen therapy;
• ingestion (intravenously in a hospital) of trental, b-adrenergic agonists.

If symptoms appear acute hypoxia the fetus requires urgent hospitalization of the pregnant woman and emergency treatment of fetal hypoxia during transportation. In acute fetal hypoxia, inhalation for 20-30 minutes of a humidified 60% oxygen-air mixture with simultaneous intravenous administration of 50 ml of a 40% glucose solution with 300 mg ascorbic acid, as well as 1 ml of a 10% solution of cordiamine. Cordiamin is administered subcutaneously or intramuscularly (2 ml each).

Inhalations of an oxygen-air mixture are used after a preliminary intravenous administration of antispasmodics or b-agonists to a woman. In addition, intravenous administration of 2-4 ml of a 1% solution of sigetin and 20-40 ml of a 20% solution of glucose, cocarboxylase (100 mg intramuscularly or intravenously) helps

If acute fetal hypoxia occurs during childbirth, the cause of this is eliminated pathological condition. Simultaneously perform the above treatment; in addition, 100 ml of a 5% sodium bicarbonate solution is injected intravenously into a woman in labor, and then 100 ml of a 10% glucose solution.

In the absence of the effect of the therapy, do operative delivery(obstetric forceps, vacuum extraction, caesarean section).

Degrees of fetal hypoxia

Diagnosis of fetal hypoxia

Every expectant mother, starting from the 20th week, keeps a self-control diary in which she notes motor activity fetus. Warning signs:

• restless behavior of the fetus;
• increased or decreased (less than three times per hour during the day) movements.

If you suspect fetal hypoxia, you should immediately consult a doctor for additional examination. It includes the following methods:

Forecast and prevention of fetal hypoxia

In the treatment of chronic fetal hypoxia, rational management of pregnancy and childbirth, the prognosis is favorable. The outcome of acute fetal hypoxia depends on the cause of occurrence, the duration of the course and the timeliness of therapeutic measures.

Prevention of fetal hypoxia includes:

Questions and answers on the topic "Fetal hypoxia"