Fetal hypoxia: what every expectant mother should pay attention to. Oxygen starvation during pregnancy or how to recognize hypoxia

Oxygen starvation fetus occurs during pregnancy in every tenth case. During pregnancy, the baby is in amniotic fluid ah mother. He cannot breathe on his own, so oxygen is transferred to him through the placenta and umbilical cord. If the child stops receiving enough oxygen, he practically “suffocates.”

Fetal hypoxia during pregnancy is considered a serious pathology and can significantly affect the health of the child and even threaten miscarriage. Against the background of a lack of oxygen in the fetal body, irreversible changes, which will subsequently affect its development.

The mechanism of oxygen exchange between mother and child occurs with the help of the umbilical cord through the blood. All substances and gases that the mother consumes are transferred to the fetus. If a woman does not have enough oxygen, the child will definitely experience oxygen starvation. On early stages During pregnancy, this is fraught with developmental anomalies; in later pregnancy, it can lead to delays in growth and development, difficult childbirth, and the inability of the child to adapt to the outside world after birth.

Causes of oxygen starvation in the fetus

Almost all reasons for the development of fetal hypoxia are primarily related to the characteristics of the mother’s life and her diseases. Also, the cause of a lack of oxygen for the child can be a pathology in the development of the umbilical cord or placenta.

Doctors distinguish two types of hypoxia in the fetus:

• acute - develops quickly, usually during the birth of a child;
• chronic - develops over some time when the child is in the womb.

The cause of acute hypoxia is various anomalies during childbirth: weak labor, wrapping the child in the umbilical cord, compression of the chest and head of the child during the passage of the birth canal.

Chronic fetal hypoxia has many causes that can develop during different stages fetal development and various ailments mother.

Fetal hypoxia can develop due to diseases in the mother such as:

1. Anemia and vegetative-vascular dystonia. Insufficient quantity hemoglobin and low blood pressure cause a lack of oxygen in the mother's blood. Thus, hypoxia also develops in the child.
2. Respiratory diseases. Bronchitis, asthma and other diseases of the lungs and bronchi lead to breathing complications. Difficulty breathing can be caused by allergies (hay fever) and a runny nose.
3. Diseases of the kidneys and urinary system.
4. Diseases of the heart and cardiovascular system.
5. Diseases associated with metabolic disorders ( diabetes mellitus).

With abnormal development of the fetus, placenta and umbilical cord, hypoxia often appears when:

• child development delay;
• high water or, conversely, low water;
• post-term pregnancy;
• multiple pregnancy;
• poor blood exchange between mother and placenta;
• infection of the fetus during its intrauterine development.

Oxygen starvation also develops with the following characteristics of the mother’s life:

• drug use, alcohol use, smoking;
• passive smoking;
• specific and difficult working conditions;
• living in places with poor ecology;
• frequent presence in smoky rooms.

Signs and symptoms of oxygen starvation in the fetus during pregnancy

If pregnancy occurs, it is necessary to register with the antenatal clinic and get tested and visit your doctor regularly. Most diseases, including fetal hypoxia, cannot be noticed by a woman on her own.

Symptoms in the early stages are invisible. Main sign lack of oxygen in a child means lethargy, slowdown in development, and attenuation of cardiac activity. Until 18 weeks, a woman practically does not feel the baby’s movement and cannot determine how mobile the baby is and how well his heart is working.

If the fetus stops moving, the mother does not feel its movement within 24 hours, or the tremors become barely noticeable, the woman should urgently seek help. Any delay can cost the child’s health and even life.

Symptoms of child hypoxia during childbirth:

• lack of screaming and movement;
• bluish skin, low temperature bodies;
• with minor hypoxia, the child simply does not have enough air, which is manifested by lethargy and lack of appetite.

Treatment and diagnosis of fetal oxygen starvation

Fetal hypoxia during pregnancy can be determined using tests and intrauterine examination of the fetus. Women who suffer from anemia and diseases internal organs, automatically fall into the risk group.

Oxygen deprivation is most quickly determined by undergoing an ultrasound. Children with hypoxia are usually smaller in height and weight. They move less frequently, more slowly (with severe pathology there may be no movement), the heartbeat is slow.

These symptoms may also be signs of another disease. To exclude them, the pregnant woman is sent for Doppler ultrasound - special study placenta, the results of which may indicate a disturbance in metabolism and gas exchange between mother and child. On later a problem with oxygen metabolism can be determined using CHT - fetal cardiotocography. It is used to determine heart rate. Normal frequency The fetal heart rate is between 110 and 160 beats per minute.

If acute hypoxia occurs during childbirth, the newborn may be treated with urgent measures on resuscitation, as well as the administration of insulin, glucose and vasodilators.

If oxygen starvation develops gradually, during gestation, therapeutic measures apply not to the child himself, but to his mother.

First, the doctor determines the cause of the lack of oxygen. In the later stages, if there is a threat of miscarriage, measures can be taken to urgently deliver the mother. The child is then placed in a special box using an oxygen mask until his viability is restored. This helps to avoid acute hypoxia during childbirth and does not disrupt the child’s development process.

If oxygen starvation is detected in the fetus, the pregnant woman is placed in a hospital under the supervision of specialists. If she has infectious or chronic diseases, they are treated first. To ensure normal oxygen exchange between mother and child, it can be used drug treatment. It is carried out using drugs such as Actovegin, Trental, etc. As additional means The use of oxygen cocktails may be recommended.

In most cases, following the rules will help the expectant mother avoid fetal hypoxia healthy image life. It is necessary to refuse bad habits, primarily from smoking. A pregnant woman is prohibited from being near smokers or in a smoky room. Need to visit more often fresh air. Regular hiking reduce the risk of hypoxia significantly. Pregnant women who are at risk (anemia, low blood pressure, diseases of internal organs) need to eat well and rest often. Regardless of the stage of pregnancy, a woman should not wear tight clothing, uncomfortable underwear, corsets or belts.

Oxygen is the most important component for the formation of a small organism. The fetus is not able to breathe on its own due to unopened and fluid-filled lungs, however, it urgently needs the oxygen coming from it in the required volume. With oxygen starvation at different stages of pregnancy, the development of the child’s organs is disrupted, which can lead to irreversible consequences.

This starvation is called fetal hypoxia, can occur at different stages of pregnancy or during childbirth and has several forms.

What is fetal hypoxia?

Fetal hypoxia is a complex pathological changes in the body of the mother, fetus and placenta, leading to disturbances in the development of the unborn child due to oxygen starvation.

Hypoxia has serious consequences at any time for the fetus, since this fasting causes developmental abnormalities, growth retardation and weight gain.

In the early stages of pregnancy, oxygen deficiency leads to untimely development of the embryo - anomalies in the development of internal organs and the brain, which leads to a number of neurological disorders in the future.

In the later stage, there is slow growth of the fetus inside the womb, damage to nervous system, decreased adaptive capabilities of the newborn.

Additionally The onset of the problem and its duration due to the disruption of any link in the supply chain in to varying degrees influences the future development of the newborn.

Invariably, hypoxia in any of its manifestations poses a threat to the health and life of the child.

Definition of hypoxia

The problem can be identified in several ways:

• On your own in late pregnancy;
• Through a medical examination.

Important In the early stages, it is necessary to constantly see a doctor and take all necessary tests, as self-hypoxia expectant mother will not determine.

When the baby begins to move, the mother can independently determine the adverse changes occurring that determine hypoxia.

The reason for such suspicions may be:

• Sluggish movement;
• Absence required quantity episodes of movement per day - during normal life, the fetus should move at least 10 times a day.

When a woman suspects a problem, she urgently needs to undergo medical examination to identify it or refute suspicions of oxygen starvation.

To identify hypoxia, the following is usually prescribed:

1. Ultrasound will show delayed fetal development, height and weight will be below normal, abnormalities in the development of the placenta also provide grounds for a more detailed examination.
2. Using ultrasound, you can determine and draw conclusions based on the results.
3. – will reveal disturbances in blood flow in the uterine ducts and placenta.
4. Listening during a doctor's visit with a stethoscope, if it is below 110 at rest and does not reach 130 during activity, this already raises suspicions of hypoxia.
5. The pathology of oxygen starvation is best identified:

• Functional load test - with increase physical activity to the mother’s body, a healthy fetus responds adequately with an increasing heartbeat, while in a patient, an arrhythmia occurs or the heartbeat remains monotonous;
• Test using cold - the frequency of strokes decreases by 10 points, the sick child does not respond;
• Holding your breath - when inhaling or exhaling, the mother holds her breath, the child reacts by decreasing and increasing the frequency of beats by 7 points, respectively, the child with hypoxia remains monotonous;
• Oxytocin test - occurs with glucose, the child must maintain a stable heart rhythm, a fetus suffering from oxygen starvation begins to react with sinus rhythm.

1. Computer monitoring of the fetal heart.
2. Critical cases require drastic measures using various techniques Ultrasound:

• – inspection of the lower pole amniotic sac through an endoscope inserted into, but such an examination has a number of contraindications and extremely rare complications;
• Placentography.

• Taking blood from the skin on the fetal head;
• Determining the presence of chronic hypoxia by analyzing amniotic fluid, which is in good condition when poured out, they are almost colorless and transparent.

Causes of oxygen starvation of the unborn child

There are many reasons for the occurrence of fetal hypoxia, among them the main ones stand out:

Information Outpatient measures are carried out to improve blood flow in the uterus and placenta, as well as to improve the metabolic processes of the fetus.

If a woman has excellent health and has no contraindications, is used in the treatment of hypoxia:

• Aqua gymnastics - reduces signs of hypoxia by improving metabolic processes in the body of the mother and fetus, as well as completely.
• A set of breathing exercises that help relax the tone of the uterus and the body as a whole, the fetus begins to absorb oxygen more efficiently.

For chronic hypoxia:

• The mother needs to be at rest, which improves blood flow in the uterus;
• Conduct active treatment the main cause of hypoxia;
• Medicines are used that improve the oxygen supply to the fetus and increase the metabolic process;
• It is very important to take sufficient daily walks throughout pregnancy to provide the body with oxygen.

If after all necessary measures the situation remains critical; emergency childbirth measures are taken from the 28th week.

Information In case of chronic hypoxia during the entire period of pregnancy, childbirth is carried out with cardiac monitoring for uninterrupted monitoring of the baby’s condition.

Drugs for oxygen deprivation

Chronic fetal hypoxia in combination with rest, in the right way life and sufficient exposure to fresh air is treated with medications:

• Eufishin, - the vessels of the uterus and placenta dilate;
• Tinipral - relaxes the muscles of the uterus;
• , – the rheological properties of blood are normalized.

In addition to these drugs aimed at directly solving the problem, it is necessary to use:

• Mixtures of amino acids and proteins – normalization of metabolic processes;
• , – stabilization of the structural and functional properties of the cell membrane;
• Antihypoxants, neuroprotectors – increasing the resistance of the brain and fetal tissues to manifestations of embryonic hypoxia.

Intrauterine fetal hypoxia

This is oxygen starvation of the fetus in the womb. This problem is not a separate disease, but is a consequence of sequential causes and complex changes in the overall chain.

The duration of oxygen starvation, the timing of the onset and course of complications completely determine the development of the fetus in the present and the health of the baby in the future.

At intrauterine hypoxia In the first stages of its occurrence, the baby becomes hyperactive; over time, the tremors weaken and their total number decreases.

Important The reason to consult a doctor is to reduce the tremors to 3 times per hour.

Intrauterine hypoxia, depending on many factors, is divided into forms:

• Lightning fast;
• Acute - occurs during labor activity, from several minutes to hours;
• Subacute – occurs 1–2 days before birth;
• Chronic – can develop at any stage of pregnancy, causing adaptation in the fetus.

Chronic

The chronic form of fetal hypoxia develops due to untimely examination by a doctor or the mother’s inattention, first of all, to the behavior of the fetus and her condition.

As a result, baby long time experiences oxygen starvation, which affects its weight and size.

These babies have a lot of problems after giving birth:

• WITH general indicators activity of the central nervous system;
• General physical development;
• Adaptation indicators;
• Lack of body weight.

All this leads to the occurrence of diseases immediately after childbirth.

The occurrence of chronic hypoxia is due to the following factors:

• or - this feature does not directly cause hypoxia, but these are symptoms of complications associated with hypoxia;
• Proeclampsia;
• Delay ;

Information Treatment of chronic fetal hypoxia is determined only by a specialist, but in any case effective fight with the disease is carried out comprehensively.

Acute fetal hypoxia

An acute form of fetal hypoxia develops during childbirth or in early pregnancy; its occurrence requires immediate intervention, as the consequences can be tragic.

Information It is not possible to predict the development of acute hypoxia at any stage of pregnancy, since everything happens suddenly.

The reason for this may be:

• Placental abruption;
• Decreased placental function in post-term fetuses;
• Uterine rupture, for example, if a woman has inflammatory diseases before pregnancy;
• Repeated entanglement of the umbilical cord.

When signs of acute hypoxia appear, minutes count, which requires immediate hospitalization of the pregnant woman.

Symptoms acute form is:

• Strong fetal heartbeat or, conversely, its weakening;
• Arrhythmia;
• Deafness of heart sounds.

During an ultrasound, a slow fetal heartbeat and inactivity are observed; the amniotic fluid has a cloudy greenish tint with meconium particles.

The development of acute fetal starvation requires immediate measures:

• Inhalation with a humidified oxygen-air mixture;
• Administration of glucose ascorbic acid, medications that normalize respiratory functions;
• In some cases surgery – C-section, overlay obstetric forceps and so on.

Acute oxygen deprivation during childbirth

The form develops as rapidly as the acute form during gestation due to improper labor.

The cause of acute fetal hypoxia during childbirth may be:

• Prolonged labor;
• Rapid labor;
• Clamping of the umbilical cord;
• Umbilical cord prolapse;
• Prolonged compression of the head;
• Incorrect presentation of the fetus.

If signs of an acute form develop during childbirth, it is necessary to immediately eliminate the cause by:

• Stimulation of labor;
• Oxygen inhalation and use of medications to restore respiratory functions;
• According to indications, surgical intervention.

Consequences of fetal hypoxia for the child

Manifestation of hypoxia in any form and absence necessary actions have negative consequences for the child in the present and future.

If hypoxia has chronic nature long acting:

• The child's embryo formation is disrupted;
• Fetal development occurs with a delay in all respects, in contrast to “peers”;
• Developmental anomalies;
• Deviations in mental and mental development baby;
• Manifestation of neurological diseases;
• This form reduces the baby’s ability to lead normal functioning after birth, since his adaptive abilities are very low.

Information Acute hypoxia has a significant difference in the quality of instantaneous development, and with long absence specialized assistance the child's death occurs.

The consequences of acute hypoxia in a rescued baby are:

• Disruption of the development of the central nervous system, due to prolonged oxygen starvation, the child lags behind in intellectual and mental development;
• Ischemic changes in the development of internal organs due to insufficient blood supply, which causes serious violations in the functioning of vital organs;
• Hemorrhages.

How dangerous is oxygen starvation for an unborn baby?

The fetus has high vital indicators and compensatory capabilities. With insufficient oxygen supply, the frequency begins to increase heart rate to maintain the necessary blood flow to vital organs - kidneys, heart, brain.

It also has a special structure of fetal hemoglobin, higher quality than that of an adult - it perfectly captures and retains oxygen.

However, in this struggle for life, intestinal hypoxia occurs, resulting in the release of original meconium.

Despite all these advantages, such protection is designed for certain time and with prolonged fasting, its levels decrease, leaving the defenseless body without adequate oxygen supply.

Due to oxygen deficiency, the functions of the nervous system are primarily disrupted, since this tissue is the most oxygen-dependent and prone to pathologies.

Lack of oxygen affects the maturation of the embryonic brain structure already at 6–11 weeks of pregnancy.

This starts to happen:

• Violation of the structure and functioning of blood vessels;
• There is a slow maturation of the blood-brain barrier, which acts as a protection for the central nervous system;
• In very severe cases of hypoxia, normal blood circulation in the various organs and tissue death, which leads to irreversible consequences.

Important A child born after a constant lack of oxygen in the womb has severe deviations in mental development.

Prevention of fetal hypoxia

To avoid even the slightest manifestation of hypoxia and the baby’s development to occur in the required direction without any pathologies, you need to:

1. If possible, plan your pregnancy and prepare seriously for it. First of all, fully prepare the mother’s body for the future of bearing a child - treat all chronic diseases.
2. Already at the onset of pregnancy, you should be carefully and promptly observed by a specialist.
3. Visits to the obstetrician should occur at least:

• 1 time per month in the first trimester;
• 1 time every 2–3 weeks in the second trimester;
• 1 time every 7 – 10 days in the third.

1. You must register with the antenatal clinic before 12 weeks of pregnancy.
2. should only contain healthy food, without preservatives, fats and spicy.
3. The daily routine must be observed properly - timely rest and sleep, moderate amount loads, without extreme.
4. Exception extreme conditions residence – frequent or abrupt change time zones.
5. Healthy lifestyle without alcohol and smoking.
6. Execution physical exercise for the purpose of development correct breathing– swimming, also singing.
7. Timely prevention of the development of concomitant diseases.
8. Correct and premature preparation for labor.
9. Subject to availability chronic diseases constant monitoring by the relevant specialist.

Bearing and giving birth to a child is the most long-awaited and wonderful period in the life of any woman; the feelings experienced by the mother at this time are so wonderful and inexplicable that the trace of these experiences remains with the woman for life.

To ensure that the joy of motherhood is not overshadowed by fetal hypoxia, it is important to make every effort and attention to give birth to a healthy and strong baby.

Fetal hypoxia is a complex of changes in the fetal body due to insufficient oxygen supply. This is not independent disease, and a consequence of various pathological processes, occurring in the body of the mother, fetus and placenta.

Oxygen deficiency leads to disruption of the body's functioning and changes in metabolic processes. IN different terms pregnancy oxygen deficiency has different consequences for the fetus. In the early stages, it leads to the appearance of developmental anomalies and slower development of the embryo. In late pregnancy, oxygen starvation leads to fetal growth retardation, damage to its central nervous system, and reduces the adaptive capabilities of the newborn.

It must be said that the fetal body has good compensatory abilities necessary to maintain the required level blood flow This is achieved by increasing the heart rate to 150-160 beats per minute, by the special structure of fetal (fetal) hemoglobin, which captures and retains oxygen better than adult hemoglobin. A decrease in blood oxygen saturation leads to changes in metabolic processes in the fetus. All his organs and systems begin to work with greater activity. The fetus strives to provide vital blood important organs(brain, kidneys, heart), this causes intestinal hypoxia, and, consequently, the release of meconium (original feces). But, unfortunately, the possibilities of these compensatory mechanisms have a limit, and with prolonged adverse effects the protection weakens. And above all, the nervous system suffers, because... It is now generally accepted that one of the most oxygen-dependent, and therefore most sensitive to the damaging effects of hypoxia, is nerve tissue, which becomes the initial object of the pathological influence of lack of oxygen.

Hypoxia delays the maturation of brain structures in the embryo from 6-11 weeks of development, causes disturbances in the structure and functioning of blood vessels, and slows down the maturation of the blood-brain barrier. This barrier is defense mechanism central nervous system - the capillary system of the brain, and any damage to it jeopardizes normal functioning brain

Minor hypoxia usually does not affect the health of the unborn child. Severe hypoxia is accompanied by ischemia (areas of blood flow deficiency) and necrosis (areas of tissue destruction) in various organs, which leads to irreversible consequences. IN postpartum period neurological disorders in a child born from a pregnancy that occurred under hypoxic conditions, vary over a wide range: from functional disorders to severe violations mental development.

Why does fetal hypoxia occur?

Factors contributing to the development of hypoxia are numerous. First of all, these are diseases of the mother. Among them, anemia is a decrease in the total amount of hemoglobin. With anemia, the main function of red blood cells is disrupted - the delivery of oxygen to the tissues of the body.

In the presence of acquired and congenital heart defects, myocardial diseases, chronic lung diseases in conditions increased load These organs in pregnant women most often experience circulatory failure, in which microcirculation in the tissues is disrupted, as a result of which the phenomena of hypoxia and disruptions in the functioning of the “mother-placenta-fetus” system gradually develop.

Diseases respiratory system (bronchial asthma, chronic bronchitis etc.) also adversely affect the course of pregnancy. They become the reason respiratory failure, the consequence of which is hypoxia of the organs and tissues of the woman and, accordingly, the fetus. Kidney disease and diabetes can also cause problems with oxygen supply to the fetus.

Other causes of hypoxia are disturbances in fetal-placental blood flow, which occurs during postterm pregnancy, the threat of premature birth, pathology of the placenta and umbilical cord, labor anomalies, and other complications of pregnancy and childbirth.

Fetal diseases also lead to hypoxia: hemolytic disease(a condition that occurs when the blood type of the fetus and mother is incompatible), intrauterine infection, birth defects development, prolonged compression heads during childbirth. As you can see, there are enough reasons.

Diagnosis of fetal hypoxia

You can independently suspect fetal hypoxia by observing changes in its motor activity. IN initial stage Restless behavior of the fetus, increased frequency and intensification of movements are noted. With prolonged or progressive hypoxia, fetal movements are weakened. This requires immediate appeal see a doctor and use additional methods studies such as cardiotocography (CTG) and Doppler, study of amniotic fluid, laboratory diagnostics. A sign of hypoxia is fetal growth retardation.

Cardiotocography is one of the modern, highly informative methods for diagnosing the intrauterine condition of the fetus during pregnancy using a cardiac monitor. The condition is assessed based on an analysis of the fetal heart rate and its motor activity. It is especially important to conduct such a study during childbirth. When executing this study two graphs are obtained: one reflects the fetal heart rate, the other shows its motor activity. At the same time, uterine contractions are recorded. By assessing how the heartbeat changes depending on movements or contractions, you can judge the condition of the baby. This study is carried out in the third trimester of pregnancy at a period of 32 weeks.

During childbirth, the main criterion for fetal hypoxia is a violation of its cardiac activity, therefore cardiac monitoring of the fetal condition is widely used during childbirth.

Doppler is one of the ultrasound methods that allows one to study the nature and speed of blood flow in the vessels of the placenta and umbilical cord, disruption of which leads to the development of hypoxia.

Ultrasound examination (ultrasound) is also important for diagnosing hypoxia. Since intrauterine development fetus from the moment of implantation - implementation ovum into the mucous membrane of the uterus - before birth it occurs in an aquatic environment ( amniotic fluid), great value to diagnose pathological conditions of the fetus, the composition, volume and color of amniotic fluid are taken into account. Almost all of the listed parameters can be assessed using ultrasound.

Normally, amniotic fluid remains homogeneous for a long time. Starting from about the 28th week in the amniotic fluid with ultrasound examination you can see a fine suspension, which is not a sign of a violation of the vital functions of the fetus. Small particles represent desquamated epithelium skin and elements of the cheese-like lubrication of the fetus - at the end of the fifth month of pregnancy (20 weeks) sebaceous glands begin to emit fatty substance, which mixes with the scales of the epidermis and forms a cheese-like lubricant that covers the skin of the fruit with a thin layer. This lubricant protects the fetal skin from the damaging effects of amniotic fluid. However, ultrasound does not fully assess the condition and composition of amniotic fluid, characteristic of hypoxia.

Pronounced changes in the volume of amniotic fluid have practical significance. Both severe oligohydramnios and polyhydramnios are signs of trouble.

Amnioscopy (amnio in Greek means “fetal membrane”, and skopeo means “examining”) - examination of the lower pole of the amniotic sac using an endoscopic device inserted into the cervical canal. Amnioscopy is used to assess the condition of the fetus if there is a suspicion of post-term pregnancy, chronic or acute fetal hypoxia, incompatibility of the blood type of mother and fetus, a burdened obstetric history (miscarriage, spontaneous miscarriages, severe gestosis, premature birth). The condition of the fetus is assessed based on color, transparency, amount of amniotic fluid, the nature of vernix flakes, the presence of meconium and some other signs. Amnioscopy has a number of contraindications, such as spotting from the genital tract (suspicion of placenta previa - a condition in which the placenta blocks the exit from the uterus), colpitis, cervicitis and others infectious processes genital tract, threat of miscarriage. Complications during amnioscopy (premature rupture of amniotic fluid and the development of labor, bleeding, infection) are extremely rare.

The color of the amniotic fluid, which also serves as an indicator of the condition of the fetus in the womb, is assessed, as a rule, in the first stage of labor, after the rupture of amniotic fluid. During a normal pregnancy, the waters are colorless and almost transparent. Coloration of amniotic fluid green Meconium (the so-called first stool) is one of the signs oxygen deficiency fetus, i.e. its hypoxia.

Treatment of fetal hypoxia

If chronic fetal hypoxia is suspected (toxicosis of pregnant women, extragenital diseases of women, etc.), the pregnant woman is hospitalized or referred to diagnostic center to study the condition of the fetus and determine the cause of hypoxia. Activities aimed at improving uteroplacental circulation and normalizing fetal metabolic processes can be carried out on an outpatient basis.

In the absence of contraindications, pregnant women can be prescribed aqua gymnastics in combination with a set of breathing exercises. During breathing exercises, the tone of the uterus and the whole body relaxes, and the process of oxygen absorption by the fetus is enhanced. Incorporating a set of aquagymnastics exercises helps to further reduce the tone of the uterus, enhance metabolic processes in the body of the mother and fetus, and the absorption of oxygen by the fetus. As a result of all measures, signs of intrauterine fetal hypoxia decrease.

For pregnant women with chronic intrauterine fetal hypoxia, rest is important. Bed rest helps improve blood supply to the uterus. It is important to treat the underlying disease that led to the development of hypoxia. Therapy is also carried out aimed at improving the oxygen supply to the fetus and normalizing metabolic processes. This therapy must be comprehensive. By using medications while trying to achieve:

• vasodilation of the utero- and fetal-placental parts of the placenta (EUFISHIN, NO-SPA);
• relaxation of the uterine muscles (GINIPRAL, MAGNE-Vb);
• in normalization rheological properties blood in the “mother - placenta - fetus” system (TRENTAL, ACTOVEGIN).

In addition, drugs are needed to normalize metabolic processes(mixtures of amino acids, proteins) that help stabilize structural and functional properties cell membranes(ESSENTIALE, CHOFITOL), increasing the resistance of the brain and fetal tissues to hypoxia (aptihypoxants, neuroprotectors).

If there is no effect from complex therapy If the condition of the fetus deteriorates during pregnancy more than 28 weeks, the issue of emergency delivery by cesarean section is resolved.

If the pregnancy proceeded under conditions of chronic intrauterine hypoxia of the fetus, childbirth is carried out with mandatory cardiac monitoring of the condition of the fetus, because this increases the possibility of diagnosing acute hypoxia and makes it possible to rationally decide on the further tactics of labor management.

A woman preparing to give birth to a child can often be “scared” by various strange symptoms and pregnancy-related diagnoses. After all main concern For every woman during this period, it means a properly progressing pregnancy, and, of course, the health of the unborn child.

That is why such a diagnosis as fetal hypoxia, or even sometimes just a suspicion of its presence, can cause real panic in the expectant mother. Of course, every woman wants to give birth to a healthy and strong baby.

But even if the doctor observing the course of your pregnancy suspects you have symptoms of hypoxia, you still shouldn’t despair. After all, all the emotional experiences of the mother are reflected in the child. So, what is fetal hypoxia and how does it manifest itself.

Fetal hypoxia, or so-called oxygen starvation of the fetus, develops if during pregnancy there is an insufficient supply of oxygen through the placenta and umbilical cord.

Of course, the first signs of fetal hypoxia during pregnancy can be detected by the expectant mother herself. But this can only happen in the second half of pregnancy, when the baby begins to move. In earlier stages of pregnancy, fetal hypoxia may not manifest itself in any way. The expectant mother, even with her presence, can feel great.

At later stages of pregnancy, a woman needs to pay attention to how actively the baby moves. As a rule, the child’s active movements can be divided into periods. That is, when the child is active and the woman feels him moving for at least a couple of minutes, and then the baby calms down for a while - this is one period. Then, after about an hour, the baby again begins to actively move in the mother’s stomach and calms down again - this next period. There should be at least ten such periods of movements per day.

Many women are worried about being too big motor activity and sometimes the so-called “hiccups” of the baby, and they consider this a sign of hypoxia. But doctors are inclined to believe that reducing the number of movements of the child is much more dangerous. And it is precisely the decrease in the number of movements of the child that serves as the main sign of oxygen starvation of the fetus or hypoxia.

The child does not have enough oxygen and freezes for a long time. It is these symptoms that should alert the expectant mother.

The doctor observing you can also identify the first signs of fetal hypoxia during regular scheduled examinations. A symptom such as hypoxia can be clearly indicated by a decrease in the fetal heart rate. Or their uneven character, acceleration and deceleration of the heartbeat, disruptions in rhythm.

In the second half of pregnancy, the baby’s heartbeat can already be clearly heard through abdominal wall. Of course, only a doctor can hear the baby’s heartbeat using a special obstetric stethoscope. When conducting routine examinations, based on regular observations, the doctor can identify symptoms of fetal hypoxia quite early and prescribe the appropriate treatment to the woman.

Besides, indirect sign, indicating the presence of fetal hypoxia, can be various deviations in the formation of the placenta. A placenta that is too thin or, on the contrary, too thick and inappropriate for the duration of pregnancy, may lead the doctor to suspect the presence of fetal hypoxia.

The beginning of placental abruption or its premature maturation is also a bad signal. Indeed, in these cases, the placenta is not able to provide the fetus with sufficient oxygen supply. Such symptoms of hypoxia can also only be identified by a doctor, based on the obtained ultrasound report of the pregnant woman.

With such signs of fetal hypoxia, a woman often requires observation of the course of pregnancy in a hospital setting.

If necessary, the doctor can give a referral for studies such as cardiotocography (CTG) or fetal Doppler. There is no need to be afraid of this. These procedures are absolutely painless and safe for the child. Such studies allow you to track the work of the child’s heart, as well as see whether the blood supply to the placenta and umbilical cord is normal.

Causes

So what can trigger hypoxia or oxygen starvation in the fetus? Every pregnant woman should know these reasons, because the sooner the presence of hypoxia is determined, the sooner you can take necessary measures to reduce it negative influence on the development of the child.

Most cases of fetal hypoxia during pregnancy are attributed to associated factors, and to a lesser extent the development of hypoxia depends on hereditary predisposition.

Chronic diseases in a woman during pregnancy can also provoke the occurrence of fetal hypoxia: gestosis, diabetes mellitus, hypertension, bronchial asthma, anemia, various diseases lungs and much more.

Also, a woman’s long stay in a stuffy room or can cause fetal hypoxia during pregnancy. long-term preservation awkward position. If a woman often lies on her back during pregnancy, the uterus can compress the inferior vena cava, which also causes symptoms of hypoxia. Therefore, pregnant women are not recommended to sleep lying on their back. Naturally, lying on your stomach is also not acceptable for pregnant women. Chronic fetal hypoxia during pregnancy can be observed if the expectant mother smokes during pregnancy.

Hypoxia can also be caused by a number of complications during pregnancy. Such as:

• polyhydramnios or large number amniotic fluid;
• pelvic diligence of the fetus;
• multiple pregnancy;
• disruptions in the uteroplacental blood supply;
• pathologies of placental development;
• fetal infections during pregnancy.

Consequences of fetal hypoxia

Unfortunately, fetal hypoxia during pregnancy can be both acute and chronic. And the severity of the manifestations of the consequences of hypoxia often depends on how rapidly the process develops.

For example, if we're talking about about premature ripening of the placenta or maternal smoking during pregnancy, the child constantly experiences a slight lack of oxygen. This is of course very bad, but does not pose an acute threat to the child’s life.

And the development of an acute process, as a rule, can lead to the most sad consequences, until the death of the baby. This situation can occur if, during pregnancy, complete premature detachment placenta. The child stops receiving enough oxygen and may soon die. The development of such a condition in a pregnant woman requires immediate medical care. In case of acute hypoxia, a caesarean section is performed, only then is it possible to save the child.

Children who were exposed to hypoxia during pregnancy are often born with underweight or stunted growth, even if the pregnancy was full-term. Sometimes there is a delay in development, increased nervousness child, pathologies of development of the cardiovascular and nervous systems.

Treatment and prevention

An acute attack of fetal hypoxia is sometimes impossible to predict and prevent. But chronic hypoxia, if detected early, can be treated and controlled. Of course, only if you strictly follow the recommendations of your gynecologist. The main advice to reduce the risk of fetal hypoxia is to avoid bad habits, if any. Also, the expectant mother should try to walk more in the fresh air, move actively if her health allows, and avoid long stays in stuffy rooms.

A necessary condition for the normal course of pregnancy is proper diet nutrition. A woman needs to eat a varied diet so that the body receives a sufficient amount of vitamins and microelements from food. Also, you need to include iron-rich foods in your diet, since iron deficiency anemia one of the reasons for the development of chronic hypoxia during pregnancy. At the same time, try not to overeat, because overweight during pregnancy, it provokes the development of shortness of breath and difficulty breathing.

Try to attend scheduled obstetrician appointments in a timely manner and take all necessary tests so that the doctor can see the presence of any abnormalities early on. Consult your doctor if you have any unpleasant symptoms or suspicion of the development of hypoxia. And also tell your doctor if you have any chronic diseases that can cause fetal hypoxia.

To prevent the development of fetal hypoxia, pregnant women are often recommended to perform special breathing exercises. good prophylactic is water aerobics. Of course, if you have no contraindications for such activities.

Sometimes, to saturate a pregnant woman’s blood with oxygen and to prevent the development of fetal hypoxia, the use of so-called oxygen cocktails is prescribed - special water or phytosolutions enriched with oxygen. Another way to treat hypoxia is to prescribe sessions in a pressure chamber for a pregnant woman. Staying in a pressure chamber is prescribed in a certain course and helps to saturate the mother’s blood with oxygen, and therefore a better supply of oxygen to the fetus.

And most importantly, even if you are directly faced with such an unpleasant diagnosis as fetal hypoxia, first of all try to remain calm and not get nervous. After all, any of your experiences are acutely transmitted to your baby.

In order for the fetus to develop as expected and the pregnancy to end safe birth, it is necessary that all processes occurring in the body of the mother and child proceed normally. Unfortunately, this is not always the case. Quite often, pregnant women are diagnosed with fetal hypoxia. How dangerous this pathology is, what causes it and what treatment is necessary, we will consider in our article.

Fetal hypoxia and its consequences

Intrauterine fetal hypoxia is a deficiency of oxygen in the fetal body, which can lead to significant consequences. As you know, with the flow of the mother’s blood through the placenta, the oxygen necessary for life is delivered to the child’s body. If oxygen is not supplied or its quantity is insufficient, then oxygen starvation of the fetus occurs. This condition can develop during pregnancy (diagnosis “chronic hypoxia”) or directly during childbirth (diagnosis “acute hypoxia”).

What happens when there is a lack of oxygen? Initially, the unborn child’s body undergoes a number of disorders that can lead to irreversible consequences if the diagnosis is not made in time and treatment is not started.

In the early stages of pregnancy, fetal hypoxia can provoke disturbances in the formation of organs and systems, the development of the embryo, and lead to various anomalies. Lack of oxygen recent months pregnancy leads to damage to the central nervous system of the fetus, disorders physical development: growth retardation, physical and mental disorders, poor adaptation of the newborn to the new environment. Children born with hypoxia have muscle hypertonicity, disorders of the autonomic nervous system, anxiety, bad dream and appetite. Children with this diagnosis are under the supervision of a neurologist for a long time.

During hypoxia, all organs and systems of the fetus work in an intensive mode, trying to get oxygen for themselves. A woman feels this, noting excessive activation and mobility of the fetus. But this does not last long, and then, if the oxygen supply is not normalized, a period of oppression begins - the fetus cannot move without oxygen and subsides. The consequences of this may be irreversible. This is why it is so important for expectant mothers to monitor the baby’s movements. If, after sudden activity, the fetus freezes (no more than 3 movements are felt within an hour), you should immediately consult a doctor. Fetal hypoxia can be diagnosed with greater certainty using cardiotocography or Doppler (when the fetal heartbeat is monitored).

Causes of oxygen starvation of the fetus

One of the possible provoking factors is anemia of the pregnant woman. The fact is that oxygen reaches all our organs and systems along with blood. It is transported by hemoglobin, which is produced with the participation of iron. With anemia, when there is not enough iron in the blood, hemoglobin production decreases. Therefore, there is less oxygen in the blood, and its supply throughout the body, including the fetus, is reduced.

The volume of circulating blood in the body of a pregnant woman increases significantly, because... Through the placenta it nourishes the fetus. If the uteroplacental exchange is disrupted, the embryo does not receive nutrients V sufficient quantity, including oxygen. This metabolic disorder between mother and fetus is observed with placental insufficiency - a violation of blood circulation in the placenta.

Smoking during pregnancy blocks the delivery of oxygen to the fetus, because Nicotine constricts blood vessels and blood circulation is impaired. The same goes for alcoholic drinks.

The development of fetal hypoxia can also be caused by the following diseases of the woman and deviations in the course of pregnancy:

• cardiovascular diseases;
• diseases of the respiratory system;
• gestosis (toxicosis);
• frequent stress;
• polyhydramnios;
• breech presentation of the fetus;
• post-maturity;
• multiple pregnancy;
• threat of premature birth;
• pathologies of the umbilical cord and placenta;
• intrauterine infections;
• labor disorders, etc.

Another factor that can provoke hypoxia is unfavorable working conditions for a pregnant woman (for example, in dusty conditions, when exposed to chemical vapors).

Thus, hypoxia is not separate disease, A pathological condition, caused by a number of changes in the body of the mother and fetus due to certain diseases and other factors.

Treatment of hypoxia

Pregnant women with the diagnosis in question, depending on the severity of the process, can be hospitalized in a hospital or treated on an outpatient basis, visiting a clinic or hospital. First of all, the cause is determined - the disease that provoked the development of hypoxia, and then appropriate treatment is prescribed.

Often, the course of treatment includes taking medications, drinking oxygenated water, following bed rest, tranquility, relaxation. If positive dynamics are not observed, the condition of the fetus worsens, and the issue of artificially induced labor is considered (for a period of at least 28 weeks).

Prevention of fetal hypoxia

The basic rule is complete failure from drinking alcohol and smoking (including passive). During pregnancy, you need to spend as much time as possible outdoors. It is even advisable to move outside the city for a while. Ventilate the premises more often, take daily walks away from highways and industrial zones. In consultation with your doctor, you can carry out breathing exercises. But we should also not forget about good rest and sleep.

Of no small importance for the prevention of hypoxia is correct, balanced, rich in vitamins and minerals in compliance with the diet, as well as the prevention of iron deficiency anemia.

It is important to regularly visit a doctor and take the necessary tests in order to detect the onset of pathology in time.

Acute fetal hypoxia

Let us separately consider acute fetal hypoxia - oxygen deficiency, which occurs directly during labor. This condition may occur due to the following reasons:

• premature placental abruption;
• pain relief during labor;
• rapid labor;
• prolonged labor;
• prolonged compression of the fetal head in the pelvic area;
• entwining the fetus with the umbilical cord.

All this can lead to fetal asphyxia (suffocation) or disorders of the nervous system.

The doctor who delivers the baby constantly monitors the condition of the fetus through ultrasound and monitors the heartbeat using cardiomotor monitoring. The development of acute hypoxia is indicated by turbid amniotic fluid (with a cephalic presentation of the fetus). In addition, acute hypoxia is diagnosed by analyzing amniotic fluid and fetal blood (pH readings).

In this case, the woman in labor is given special drugs intravenously and intramuscularly, and carry out other measures to combat hypoxia. In the absence of effect and a prolonged increasing state of oxygen deficiency, the question of surgical resolution is raised (caesarean section, obstetric forceps, vacuum extraction). The outcome of acute hypoxia depends on the speed of these measures.

Author of the publication: Alexey Kulagin