The normal course of pregnancy can greatly complicate the diagnosis, which sounds threatening to the expectant mother - “fetal hypoxia.” According to statistics, every third pregnant woman faces this problem to one degree or another. Why a child begins to suffer from a lack of oxygen and why this is dangerous for his health, we will tell you in this article.

What it is?

Fetal hypoxia is a state of oxygen starvation in which the child suffers quite severely. Most expectant mothers experience chronic hypoxia, in which the lack of oxygen in the baby lasts for quite a long time. Sometimes the condition is acute, and this is very dangerous for the fetus, as it can lead to the death of the child in utero from asphyxia.

With an insufficient level of oxygen, which the baby receives through the bloodstream for 9 months, serious changes occur in his body - metabolism changes, pathological changes are observed in the baby’s nervous system.

If the hypoxia is insignificant, the baby is quite capable of coping with this condition with virtually no consequences for himself, since the compensatory mechanisms even in an unborn baby are incredibly large. Thus, the baby “stocks up” with oxygen in advance, since the number of O2 molecules in his blood is much higher than in the blood of an adult, so when starvation occurs, he will be able to consume his own reserves for some time. In addition, the baby’s adrenal glands quickly respond to a lack of oxygen, which immediately respond by producing hormones that allow them to temporarily increase blood pressure and normalize the heart rate.

Despite all this, these mechanisms, unfortunately, are not able to compensate for prolonged hypoxia or acute hypoxia of the fetus. When a gynecologist who is observing an expectant mother speaks about the presence of fetal hypoxia, he must clarify the degree of the problem in question. 1st degree - insignificant, the second and third may be the basis for hospitalization of the pregnant woman or premature birth if the baby’s condition is threatening.

The lack of oxygen during pregnancy is usually chronic.

Acute hypoxia most often develops during childbirth. It is provoked by incorrect actions of medical personnel - stimulation of contractions with strong medications, aggressive acceleration of the birth process.

Doctors can predict possible consequences for the child already in the delivery room, since the condition of the baby immediately after birth speaks volumes. Depending on him, he is given the first assessments in his life - points on the Apgar scale; this assessment system necessarily includes an assessment of the post-hypoxic state. The lower the score, the more serious the problems may be in the future. A child born with acute hypoxia is characterized by low scores in the first 10 minutes after birth, but after an hour the child can safely be given an Apgar score of 7-8. In this case, the forecasts are positive. If the baby’s condition does not improve or begins to deteriorate, the prognosis is not so rosy.

Causes

Chronic hypoxia can appear for a number of reasons:

• maternal diabetes;
• viral infection suffered in the first trimester of pregnancy;
• pregnancy with twins or triplets;
• prolonged state of threatened miscarriage, threatened miscarriage;
• partial placental abruption, bleeding;
• post-term pregnancy (more than 40 weeks);
• anemia of a pregnant woman;
• disruption of uteroplacental blood flow;
• bad habits - smoking during pregnancy, drinking alcohol, taking drugs.

Acute hypoxia occurs in cases of complications during childbirth with:

• entwining the baby with the umbilical cord and pinching the umbilical cord ring;
• polyhydramnios;
• pregnancy with twins or triplets;
• premature placental abruption, which often happens during fast, rapid labor or during labor that is stimulated by puncture of the amniotic sac or medication;
• primary or secondary weakness of generic forces.

Diagnostics

Diagnosing fetal hypoxia is not an easy task, because babies behave differently in the womb. One is lazy due to temperament and rarely moves, the other is active, and his frequent movements are often mistaken by both women and doctors for a manifestation of hypoxia. Some symptoms should alert you:

• a change in the nature of the motor activity of the fetus, in which at first the baby moves chaotically and often with strong painful tremors, and then, as oxygen starvation develops, movements become increasingly rare;
• the height of the fundus of the uterus is significantly lower than normal;
• the child develops with a noticeable lag (fetometric indicators are below the lower limit of normal);
• A pregnant woman is diagnosed with oligohydramnios.

In the later stages of pregnancy, doctors advise monitoring the baby’s movements especially carefully; the number of movements should be recorded in a diary.

Normally, a awake baby should make up to 10 movements per hour. These can be revolutions, easily perceptible and distinguishable, and barely noticeable movements. It is recommended to register movements from 20-22 weeks of pregnancy until its end.

If a doctor, based on the deviations from the norm described above, suspects hypoxia, he will definitely prescribe a CTG for the pregnant woman. During cardiotocography, sensors attached to the abdomen will record all the baby’s movements, changes in his heart rate, and even hiccups will be reflected. Additional research methods include Doplerometry, fetal ECG, and ultrasound examination (this differs from the standard ultrasound procedure in that the doctor will look not at parts of the child’s body, but at the speed of blood flow in the uterine arteries and in the umbilical cord). An extended blood test from the mother’s vein, in addition to the listed methods, makes it possible to determine whether there is enough hemoglobin in the blood and to clarify other biochemical factors.

Acute labor hypoxia does not require extensive diagnostics, since the fetal monitor, operating in real time, immediately registers the pathological state of oxygen starvation in the child as soon as it occurs.

The most reliable sign is considered to be bradycardia - a decrease in heart rate in a baby who has not yet been born. If the normal heart rate of the fetus is from 120 to 170 beats per minute, then in a baby who suffers oxygen starvation, the heart rate will be at the level of 80-90 beats per minute. Tachycardia also indicates a lack of oxygen if the child’s heart rate is above 180-190 beats per minute.

The amniotic fluid in which a child with chronic hypoxia was located is sometimes dark or dark green in color, with an unpleasant odor of meconium (the original feces of a newborn). After birth, the baby himself will be weaker compared to other babies, he will have decreased or increased muscle tone, and neurological disorders of varying degrees of severity.

Possible consequences

The most formidable, but, alas, very real consequence of oxygen starvation is brain hypoxia. It is the brain that suffers from hypoxia more often and more severely than other organs. Even the most experienced doctor cannot predict what disorders will be caused by dysfunction of one or another part of the brain in the perinatal period. However, after childbirth, it is quite possible to assess the traumatic impact. And if some disorders, such as problems with speech development, become obvious later, then severe hypoxic-ischemic lesions of the central nervous system in most cases can be diagnosed in the maternity hospital, in extreme cases - in the very first months of the baby’s life.

The consequences for the nervous system due to brain cells dying due to oxygen deficiency can be different - from moderate hyperactivity of the child in the future to severe damage, which includes cerebral palsy, paresis of various dislocations. During complicated childbirth in a state of acute hypoxia, cerebral hemorrhage, ischemia, and cerebral edema often occur. The damage that occurs with such violations can be total and irreversible.

Both acute and chronic oxygen deficiency can lead to a wide variety of diseases, mainly neurological. Thus, problems with vision or hearing are a fairly common post-hypoxic consequence. If hypoxia has been prolonged, then the child may have underdevelopment or abnormal development of some internal organs, heart defects, kidney defects, and so on. In most cases, a child manages to “outgrow” minor neurological disorders by the age of 6-7, naturally, with constant monitoring by a neurologist and following all his recommendations.

In general, the prognosis regarding possible consequences directly depends on how early hypoxia was detected and how promptly treatment was provided. That is why women are not recommended to miss the next consultation appointment, and women with chronic diseases have to visit the obstetrician two to three times more often.

Treatment during pregnancy

The established fact of hypoxia during pregnancy should in no case be ignored; quick and effective therapy is needed to minimize possible consequences for the baby. Doctors urge expectant mothers, first of all, to calm down, since unnecessary nervous worries only aggravate the already quite complex condition of the child.

In later stages, severe hypoxia may become an indication for urgent delivery by cesarean section. At earlier stages, when the baby is still very early to be born, doctors will try to do everything possible to make the baby feel better. Treatment can be done at home, but provided that the severity of hypoxia does not exceed grade 1. The remaining cases are subject to urgent hospitalization and constant monitoring of the pregnant woman and baby in the hospital.

Doctors prescribe bed rest for mothers; it is during this time that the blood supply to the placenta increases and minor hypoxia can be cured in the shortest possible time. The main approach to drug therapy is the use of drugs that improve uteroplacental blood flow, such as “Curantil”, “Actovegin”. In case of severe hypoxia, these drugs are administered intravenously by drip. In other situations, it is allowed to take pills. The woman is prescribed vitamins, iron and magnesium supplements. Treatment courses are repeated.

Until the baby is born, his lungs are filled with fluid and oxygen does not flow through them. The fetus receives oxygen through the placenta, which receives it from the blood of the pregnant woman. And if a malfunction occurs in any area, as a result of which the supply of oxygen to the fetus is impeded, intrauterine fetal hypoxia begins to develop. Today, approximately one tenth of pregnancies and childbirths experience this phenomenon. And even a high level of medical knowledge and measures taken to eliminate hypoxia are not able to reduce the number of cases of this pathology. What are the reasons for this phenomenon and how to prevent it?

What is intrauterine hypoxia?

The word hypoxia refers to a state of lack of oxygen in the tissues and cells of the body, in which their normal functioning is impossible. This pathology can occur in the early stages of pregnancy and just before childbirth, and also interfere with its favorable course.

Hypoxia itself is not a disease, it is a condition that is caused by a number of changes in the body of a woman or fetus. All these changes lead to a lack of oxygen, resulting in disturbances in the functioning of organs and, as a consequence, the development of various defects. According to the international classification of diseases, tenth revision, ICD 10, intrauterine fetal hypoxia is assigned code 036.

Intrauterine hypoxia: classification

Based on the speed of development, severity of manifestations and duration of exposure, the following degrees of intrauterine fetal hypoxia are distinguished:

Acute;
chronic.

Intrauterine fetal hypoxia that occurs during childbirth is called acute. Usually, all children experience some oxygen deficiency during the birth process and are quite well adapted to this temporary phenomenon; this will have virtually no effect on the health of the unborn baby. However, in case of complications of the birth process, hypoxia can be very dangerous.

Acute intrauterine hypoxia occurs when:

Rapid labor;
with prolonged compression of the head during childbirth;
umbilical cord prolapse;
during prolonged labor;
bleeding and other complications.

Sometimes acute hypoxia can also be observed during pregnancy, when the uterus ruptures or the placenta begins to exfoliate, resulting in a threat of disruption to the vital organs of the fetus. Severe hypoxia is accompanied by necrosis, blockage of blood vessels and leads to irreparable results.

If oxygen stops flowing to the fetus, asphyxia occurs, that is, suffocation. With such a diagnosis, in order to save the child’s life, emergency surgery should be immediately performed to remove the child.

Chronic intrauterine hypoxia develops gradually over a long period of time during pregnancy. This happens in cases where the pregnant woman was not under the supervision of a doctor, was not examined or treated.

Lack of oxygen at different stages of pregnancy has different effects on the fetus. In the early stages, when all the organs of the unborn child are formed, hypoxia can lead to abnormalities in the development of the embryo, including its brain. At the end of pregnancy, hypoxia causes fetal growth retardation, affects the central nervous system, and leads to a decrease in the child’s adaptive capabilities. In severe cases of hypoxia, it may be necessary to perform an early cesarean section.

The combination of acute and chronic hypoxia can lead to the most serious complications.

The consequences of intrauterine hypoxia can be very different:

If hypoxia was observed during childbirth, the baby may swallow amniotic fluid, which can lead to his death;
in the case of chronic hypoxia, in the absence of appropriate treatment, the child may experience developmental delays and health problems in the future;
in particularly difficult cases, there is a risk of intrauterine fetal death.

Symptoms

Signs of intrauterine hypoxia appear depending on the duration and degree of oxygen deficiency:

At the initial stage, there is an increase in the fetal heart rate, restless behavior, and increased motor activity;
with severe hypoxia, the heartbeat slows and heart sounds are muffled, fetal activity decreases, fetal movements slow down;
the appearance of meconium, or the baby’s original feces, in the amniotic fluid; in this case, the water turns brown-green.

If there are up to three fetal movements per hour, a heartbeat below one hundred beats per minute or above 160, there is cause for concern.

Causes

Many factors can cause fetal hypoxia:

1. Primarily, the causes of intrauterine fetal hypoxia are maternal diseases:

Anemia, that is, a low level of hemoglobin, as a result of which the supply of oxygen to the tissues and cells of the body is disrupted;
respiratory diseases;
various kidney diseases;
diabetes;
severe toxicosis;
metabolic disorders and hormonal disorders.

2. Various fetal pathologies:

Hemolytic disease, Rh conflict;
intrauterine infection;
congenital malformations;
prolonged compression of the fetal head during childbirth;
impaired blood supply to the placenta.

3. Disturbances during childbirth:

Post-term pregnancy;
premature birth or its threat;
incorrect presentation of the fetus;
pathologies in the development of the placenta;
multiple or polyhydramnios births;
use of anesthesia;
other complications during childbirth.

The cause of intrauterine hypoxia can also be a psychological factor. In stressful conditions, anxiety, fear, a woman’s breathing is disrupted, she begins to breathe less often, as a result of which the supply of oxygen to the fetus is disrupted.

Diagnostics

In the early stages, it is almost impossible to detect hypoxia. If a pregnant woman has the diseases that we mentioned above, then we can make an assumption about possible problems with the oxygen supply to the fetus. But after the woman begins to feel the movement of the fetus in the uterus, one can judge the condition of the child by its activity.

At the beginning of the development of hypoxia, fetal movements become active, sharp, and sometimes the woman even experiences severe pain. With further development of hypoxia, the child’s movements become sluggish and can sometimes cease to be observed. You should immediately tell your doctor about this and undergo an examination. And starting from 28 weeks of pregnancy, doctors recommend that a woman keep a diary in which it is necessary to note the activity of the fetus. If a woman notices that the baby has moved less than ten times in the last twelve hours, she needs to tell the doctor about it. Doctors, in turn, use the following methods to assess the condition of the fetus:

Listening to the fetal heart sounds with a stethoscope; if the heart rhythm, tone, or noises cause concern to the doctor, further examination is carried out.
Cardiotocography, in which the study is carried out using special equipment with an ultrasound sensor. The sensor allows you to record indicators on paper for subsequent analysis and determination of possible deviations in heart rhythm.
Dopplerometry - allows you to evaluate the process of blood circulation and identify the nature of changes.
Fetal ECG - will provide information about the condition of the fetus.
Conducting a laboratory examination.
If intrauterine hypoxia is suspected, it is necessary to analyze the amniotic fluid. With a lack of oxygen, the baby's rectal muscles involuntarily contract, and feces are released into the amniotic fluid. If it is present, the entire tactics of childbirth will change.

For various complications during childbirth, a diagnostic method such as amnioscopy is used. This method involves testing blood taken from the skin of the baby's head during childbirth.

To obtain a more complete picture of the fetal condition, several research methods are usually used simultaneously.

Modern diagnostics make it possible to fairly accurately identify the problem and determine the best ways to eliminate it. The expectant mother should not panic unnecessarily, but if there are reasons for concern, she should not hesitate, in this case it is better to be safe.

Treatment of intrauterine hypoxia

The sooner the presence of fetal oxygen starvation is detected, the more effective the treatment will be and the fewer complications can be expected.

If there are no indications for immediate fetal extraction, therapy is prescribed. Treatment of intrauterine fetal hypoxia consists of getting rid of the cause that led to this condition, as well as subsequent treatment of the manifestations of hypoxia. First of all, drugs are prescribed whose action is aimed at improving blood circulation in the placenta, to stimulate metabolic processes between the fetus and mother, and drugs to improve the oxygen supply to the fetus. The main thing for a woman is to be at rest, stay in bed and follow all the doctor’s recommendations.

An obstetrician-gynecologist who delivers a baby regularly listens to the baby’s heartbeat. If after treatment positive changes do not occur, oxygen starvation of the fetus increases, then after 28 weeks of pregnancy, doctors may raise the question of performing a cesarean section.

The condition of a newborn in the first minute of life is assessed using a ten-point Apgar scale. A score below five points indicates that the child is hypoxic. The newborn's airways are first cleared of fluid, warmed, and, if necessary, resuscitation measures are carried out.

After the child’s condition has stabilized, in case of intrauterine hypoxia, the newborn is placed in a pressure chamber, in which comfortable conditions for the child’s development are maintained, and further therapy begins. In the first month, the child is easily excitable, sometimes, on the contrary, lethargy is noted. But subsequently the condition improves.

At the age of six months, symptoms of hypoxia may return and convulsions may appear; the duration of this period will depend on the extent of the child’s brain damage.

Prevention

Every expectant mother should think not only about herself, but also about the future baby, and know how to prevent intrauterine fetal hypoxia. Even during the first examination by a gynecologist when registering, you need to tell him about all the diseases you have suffered and your current state of health. The best prevention of intrauterine hypoxia is:

Healthy sleep;
complete rest;
getting rid of all bad habits;
exclusion of exposure to harmful factors: cigarette smoke, time zone changes, climate;
healthy lifestyle;
regularly take walks in the fresh air;
a balanced diet, foods containing iron should be a must on your table;
mandatory early registration and regular visits to the doctor;
avoid stressful situations;
Moderate physical activity and swimming are useful;
in order to prevent hypoxia, you can perform breathing exercises or singing to train your breathing;
preparation for pregnancy;
correct choice of delivery method;
taking care of your health, timely treatment of diseases.

Restoring the health of a child born with hypoxia

To restore the health of a child born with hypoxia, it is necessary:

Observation by a neurologist in order to promptly identify the appearance of possible pathologies and carry out appropriate treatment;
the atmosphere in the house should be calm;
A comfortable temperature regime must be maintained so as not to expose the child to either hypothermia or overheating;
It is better to refrain from swaddling and give the child the opportunity to move freely;
take care of breastfeeding, which should continue as long as possible;
give the child a special massage, gymnastics, herbal baths;
in more complex cases, carry out treatment prescribed by a specialist, special massages, physiotherapeutic procedures, treatment from highly specialized specialists.

Fetal hypoxia is an intrauterine condition manifested by disorders of organs and tissues, occurring against the background of a lack of incoming oxygen. Most of all, the functioning of the central nervous system is affected. Fetal hypoxia during pregnancy occurs in every tenth woman.

Oxygen starvation of the fetus is formed against the background of disturbances in the transport of nutrients through the placenta. The manifestations and consequences of this condition can vary greatly, depending on the time of onset of hypoxia.

If it begins late in life, it usually results in slight delays in development and growth. With a lack of oxygen in the early stages, defects are formed that are irreversible.

It is important to understand that hypoxia is not an independent disease. This violation is evidence of pathological processes occurring in the body of the mother or fetus.

Why is it dangerous?

The main danger of this condition is its systemic effect on all organs. Depending on the affected area, the disease may be complicated by the following conditions::

• encephalopathy;
• convulsive syndrome;
• lack of reflexes;
• pulmonary hypertension;
• congenital heart defects;
• kidney failure;
• inflammatory bowel diseases;
• immunodeficiency.

Expert opinion
Fergert Andrey
Fetal hypoxia is the most common cause of asphyxia - a pronounced impairment of respiratory function in a newborn, in which breathing is absent or irregular, but cardiac activity remains. The main danger is that without special resuscitation measures there is a high risk of death.

Degrees of hypoxia

Depending on the severity, there are three degrees of the disease:

• mild (exclusively hemodynamic disturbances);
• medium (disorders of all metabolic processes);
• severe (changes affect organs and tissues).

If with mild and moderate severity everything often returns to normal, then with severe severity there is an option for the irreversibility of the changes that have occurred.

Forms of hypoxia

Experts identify many forms of the condition, but more often you can find a classification based on the time course of the disease. So, there is acute and chronic hypoxia. Also, some experts identify a subacute form of the disease.

The acute form most often occurs during childbirth. Chronic, possible in case of lack of oxygen for a long time. In this case, the main reason is functional disorders of placental activity.

Depending on the mechanism of formation, there are the following forms of the disease:

• arterial;
• hemic;
• ischemic.

We should also talk about a mixed form, which is characterized by manifestations of two or more types of hypoxia.

Symptoms

The first thing you need to understand is that this disease does not have characteristic clinical manifestations that can accurately indicate hypoxia. Therefore, in addition to the medical history and collection of complaints, examination data is important for the specialist.

Advice for pregnant women

The doctor will look at the ultrasound, CTG (study of the fetal heartbeat) and only after that will be able to make an accurate diagnosis. Initial signs of the disease may not be detected even after an instrumental examination.

The first thing that will allow you to understand that the child has hypoxia, or rather to suspect it, is the mother’s complaints. Thus, with hypoxic damage, a pregnant woman may present the following complaints:

• poor fetal movements (from four months of pregnancy there should be at least 8 baby movements per day);
• manifestations of the underlying disease (anemia, pyelonephritis and other chronic pathologies are very often detected);
• weakness;
• headache.

There are no specific manifestations; most often, changes are detected during preventive examinations.

Causes

People are interested in what causes fetal hypoxia. According to most experts, there are many reasons why this condition occurs. Hypoxia can be caused by the following diseases that a pregnant woman suffers from:

• pathology of the heart or blood vessels;
• anemia (with this condition there is a decrease in the total amount of hemoglobin, which leads to a decrease in oxygen delivery to the fetal tissues);
• systemic diseases (diabetes mellitus, lupus, etc.);
• pathologies of the respiratory system (asthma, chronic obstructive pulmonary disease, pneumonia);
• kidney pathologies.

Frequent causes of hypoxia are disturbances in the circulatory system through the placenta. These include:

• diseases of the placenta or umbilical cord;
• pathologies of labor;
• late or early gestation.

Some fetal diseases can also lead to a hypoxic state. These include any defects and infectious diseases that develop during the prenatal period. In some cases, it leads to a hypoxic state hemolytic disease newborn

You need to understand that any maternal disease that does not directly lead to fetal hypoxia can worsen the condition, increasing the risk of developing any pregnancy complications, including hypoxia. This is why it is so important for a pregnant woman to monitor her health and promptly seek help from a specialist.

How to determine

Diagnosis of fetal hypoxia should be comprehensive. This is due to the fact that different degrees of the disease may be indistinguishable when examined using one method. One of the simplest methods is auscultation. This technique allows you to identify changes in heart sounds:

• arrhythmia;
• noises;
• reduction in sonority;
• tachy- or bradycardia.

It is difficult to recognize fetal hypoxia during pregnancy using this method. Moreover, the changes revealed in this case may indicate not only oxygen starvation of the fetus, but also other diseases.

Self-diagnosis and therapy is contraindicated

It is impossible to independently determine hypoxia by heartbeat, even if changes were detected independently, you must immediately seek help from your doctor. He will not only make the correct diagnosis, but also help you choose the necessary treatment.

The non-stress test is a very accurate test that determines the acceleration of fetal development. If during this method there is no increase in heart rate, we can talk about a violation of adaptation mechanisms. It is recommended to combine this method with the following data:

• breathing movements;
• amount of amniotic fluid;
• muscle tone;
• body movements.

The above data is a biophysical profile of the fetus. Violations of these values ​​may indicate fetal problems, including helping to check oxygen deficiency.

Cardiotocography is the most informative technique through which fetal hypoxia is diagnosed. The procedure is based on recording the fetal heartbeat by placing special sensors on the pregnant woman’s stomach. For a specialist, changes in heart rate are informative. Normally, only occasional slowdowns in rhythm are allowed.

Screening every trimester is mandatory

Ultrasound examination is also of great importance for determining changes occurring in the fetus. It is necessary to visit a specialist for this examination not only at the beginning of pregnancy, but also in the third trimester. Only if you do not skip preventive examinations will the doctor have the opportunity to detect the disease in the early stages and begin treatment measures.

Treatment

Therapeutic measures should be carried out under the strict supervision of the attending physician. The first thing to do is to eliminate all risk factors and treat the underlying disease against which hypoxia developed.

The patient is prescribed bed rest. It is recommended to lie on your left side, as this eliminates the possibility of inferior vena cava syndrome. Treatment at home is not always allowed. Severe hypoxia may require hospitalization. Experts also prescribe and inject drugs to reduce uterine contractility:

• papaverine or no-spa;
• bricanyl;
• ginipral (drip for a long time).

Complex treatment must necessarily include drugs that reduce blood viscosity. These include rheopolyglucin and chimes. Aspirin use is not recommended and is allowed only when directly prescribed by the treating specialist.

According to recent studies, treatment must necessarily include agents that improve metabolic processes, as well as antioxidants. These include:

• vitamins E and C;
• glucose solution;
• glutamic acid preparations.

In the acute phase of the disease, the following drugs can be prescribed to increase uteroplacental circulation:

• sigetin;
• chimes;
• aminophylline;
• rheopolyglucin;
• glucose with insulin.

If after therapeutic measures there is no improvement in the condition of the fetus, emergency delivery by cesarean section is resorted to.

How to avoid

There are no specific preventive measures. But to reduce the risk of developing a hypoxic state, the following recommendations must be followed:

• eliminate bad habits;
• spend more time walking in the fresh air;
• do not miss preventive examinations with a gynecologist, and also undergo all examinations in a timely manner;
• exclude anemia;
• prevent exacerbation of chronic diseases;
• If you have any complaints, immediately seek help from your doctor.

Following these recommendations will not completely prevent the disease, but it will improve the development of the fetus and also reduce the risk of complications during pregnancy. A pregnant woman should pay special attention to preventing the exacerbation of her chronic diseases. They are often the cause of hypoxia, which is why it is so important to prevent them.

Consequences

Hypoxia is a dangerous condition that leads to various complications depending on the severity and period at which it occurs. If severe in the first trimester, the disease can lead to birth defects, some of which may be incompatible with life.

When appearing late in life, the main problem is a disruption in how the baby develops. In this case, after birth a diagnosis of perinatal damage to the central nervous system will be made. In this case, the risk of complications is not high. Usually, after two months of drug therapy, the child returns to normal and continues to develop according to age.

What is fetal hypoxia -

A fetal condition that occurs due to a lack of oxygen supplied through the mother's placenta. According to statistics, hypoxia in the CIS countries occurs in 10.5 cases out of 100 births.

In the womb, as is known, the child cannot obtain oxygen from the air on its own. Like other nutrition, it receives air through the placenta. At the baby's place (where the placenta is attached to the fetus), the vessels of the uterus and placenta are connected. Through them, nutrients flow from the mother’s blood directly into the body of her unborn child. If the mother lacks any elements (in this case, oxygen), the child will also feel their deficiency.

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Other diseases from the group Children's diseases (pediatrics):

Although this condition has been well studied, and treatment methods have long been developed, fetal hypoxia remains the cause of many diseases in a newborn baby. Parents must understand what this process is and what actions should be taken to protect the baby from trouble.

While in the womb, the baby is unable to breathe on its own. The baby’s organs and systems are just developing, their functions are becoming established. The baby's lungs are immature, and the airways are filled with fluid. The fetus receives the necessary oxygen through the placenta. It is this organ that ensures the supply of invaluable gas to the baby’s body. If there is not enough oxygen supplied, then they speak of fetal hypoxia.

Although essential gas and nutrients are transferred from mother to fetus through the circulatory system, their blood is not mixed. The placenta protects the baby from harmful substances entering the body. But, unfortunately, medications, alcohol, drugs and viruses easily overcome the obstacle.

Intrauterine fetal hypoxia is not identified as a separate disease, but indicates a state of oxygen deficiency in the baby. This problem can be caused by changes in the placenta, the body of the mother or child, which lead to adverse consequences.

Reasons for the development of intrauterine fetal hypoxia:

1. Mother's diseases. In some situations, a woman’s body does not allow her to give her baby the necessary oxygen. With anemia, heart and vascular diseases, pathology of the kidneys and respiratory system, the risk of developing oxygen starvation of the embryo increases. Toxicosis in a pregnant woman, diabetes mellitus, and bad habits of the mother have an adverse effect on the health of the baby.
2. Disturbances in the placenta-fetus system. Pathologies of the placenta and umbilical cord, circulatory disorders in the event of a threatened miscarriage or post-term pregnancy, anomalies in labor inevitably affect the health of the child.
3. Causes related to the fetus. When a baby is infected in utero, the risk of developing hypoxic conditions increases. Unfavorable factors also include congenital anomalies, hemolytic disease of the fetus, multiple, tight entanglement of the umbilical cord around the child’s neck, and multiple pregnancies. Complications that arise during childbirth also often lead to oxygen starvation of the fetus.

The manifestations and severity of symptoms of hypoxia largely depend on the course and time of occurrence of the pathological condition. Therefore, clinicians distinguish 2 forms of hypoxia:

1. Acute fetal hypoxia. This disorder develops quickly, usually during labor, as the baby passes through the birth canal. For example, during rapid or protracted labor, when the umbilical cord loops fall out or the head is retained in the woman’s birth canal, an acute disruption of the flow of blood through the umbilical artery occurs. The baby does not receive gas and experiences severe oxygen starvation. During pregnancy, acute hypoxia often occurs against the background of placental abruption and can lead to premature birth or require emergency surgery - caesarean section.
2. Chronic fetal hypoxia. Oxygen starvation can develop gradually; the baby does not receive enough gas for a long time. The cause of chronic intrauterine hypoxia is most often pathologies of pregnancy, lack of proper treatment, and chronic diseases of the mother. Often this condition develops in women who ignore visiting antenatal clinics.

During an ultrasound examination of a pregnant woman, the doctor may notice that the fetus lags behind its “peers” in physical parameters and looks younger than its gestational age. If hypoxia develops in the second half of pregnancy, then the weight of these children does not correspond to their height, and malnutrition occurs. Newborns are more prone to developing diseases and autonomic disorders.

Nervous tissue is very sensitive to oxygen deficiency; it is the tissue that suffers first during hypoxia. Already at 6–11 weeks, oxygen starvation of the child’s nerve cells leads to a delay in brain development. The next organs suffering from hypoxia are the kidneys, heart, and intestines of the unborn child.

The first sign of hypoxia is a change in fetal motor activity. The baby becomes low on oxygen; in response to the low gas concentration, the motor centers in the brain are excited, and the baby actively moves.

A woman should be alerted to the increased frequency of movements of the baby, which does not go away even at rest, in the absence of loads. During the examination, the doctor detects an increase in the fetal heart rate of more than 160 beats per minute.

Although the unborn child makes its first movements already at 7–8 weeks of pregnancy, the woman notices movements at 16–18 weeks of obstetric period. Starting from the 24th week of gestation, babies actively “communicate with their mothers,” making about 10 pushes per hour.

If the disease is not detected in the early stages, the child’s condition worsens. There is a serious lack of oxygen, which leads to a decrease in the baby’s activity. The baby's strength is depleted, and movements are reduced. During the examination, the doctor notices a decrease in the fetal heart rate.

A woman must consult a doctor if she notices a weakening or lack of physical activity for 12 hours. A terrible sign is the child’s sudden calming down after prolonged excessive movements.

Assessment of the fetal condition should be comprehensive and include several methods that complement each other:

The study is carried out every time a woman visits a antenatal clinic, starting from 18 to 20 weeks of pregnancy, when drying of the fetal heart becomes possible. To do this, an obstetrician-gynecologist uses a stethoscope - a device that is a tube with funnel-shaped extensions at both ends. The doctor places the wide part of the device on the mother’s abdomen in the area of ​​best listening to the fetal heart.

Using an obstetric stethoscope, you can evaluate the heart rate, rhythm and sonority of tones. Manipulation is also used during childbirth to assess the fetal response to uterine contractions - contractions.

Due to its simplicity and low cost, the method is widely used and has no contraindications, but the accuracy of the study is inferior to instrumental ones. In addition, the baby’s heartbeat cannot be heard during a contraction, and the error in counting heart contractions reaches 10–15 beats.

1. Cardiotocography (CTG).

The method has proven itself in the diagnosis of hypoxic conditions of the fetus. The essence of the study is to record the electronic activity of the heartbeats of the unborn child. To do this, a special sensor is attached to the bare belly of a pregnant woman, which records the fetal heartbeat and uterine contractions. The data obtained during the examination are recorded on a sheet of paper in the form of curves.

An experienced specialist then interprets the cardiotocography results. Modern devices have an automatic decoding function, which helps the doctor make an accurate diagnosis.

The following CTG parameters are subject to evaluation:

• basal rhythm - average heart rate, normally 110 - 160 beats per minute;
• amplitude - a violation of the regularity of contraction of the heart muscles, normally ranging from 5 to 30 beats/min;
• decelerations - periods of decreased fetal heartbeat, repeated episodes of which may indicate serious oxygen starvation in the child;
• acceleration - episodes of increased heart rate that occur when the uterus contracts or increases the motor activity of the fetus, and does not exceed 3 in a quarter of an hour.

1. Ultrasonography.

The method is absolutely safe and highly informative, therefore it should be carried out as a screening examination for all women. Typically, ultrasound is performed three times: at 11–13 weeks, 20–21 and 30–34 weeks.

In addition, the doctor may order an unscheduled study if indicated. The essence of the method is to reflect the ultrasonic waves sent by the sensor from the organ being examined. These signals are recorded and reproduced on the device monitor.

Using an ultrasound, the doctor determines the baby’s health status, the proper development of organs, and the baby’s motor activity. Of great importance is the assessment of the condition of the placenta, its size, location, thickness and degree of maturation.

To determine fetal hypoxia, ultrasound is complemented by Doppler measurements, which record the movement of blood in the vessels. Modern ultrasound machines are equipped with a Doppler function.

For each stage of pregnancy, a certain method for diagnosing hypoxia is suitable. In the first trimester, ultrasound is most informative; Doppler ultrasound is indicative in 18–26 weeks of pregnancy, and determination of the fetal bioprofile from the 26th week. The cardiotocography method is most informative after the fetus reaches 30 weeks of gestation.

Assessing the biophysical profile of the fetus allows you to comprehensively assess the health of the baby and identify hypoxia. For this purpose, ultrasound data and the results of a non-stress CTG test and assessment of the frequency of accelerations are used.

During the study, 6 parameters are determined:

• fetal breathing movements;
• physical activity of the baby;
• number of accelerations;
• volume of amniotic fluid;
• muscle tone of the fetus;
• maturity of the placenta.

Each indicator is scored from 0 to 2 points, which are then summed up. A result of more than 8 points is considered normal, and less than 4 indicates severe hypoxia.

How the lack of oxygen will affect the health and extrauterine life of the baby depends on the severity of hypoxia and the duration of pregnancy. Oxygen starvation in the first third of pregnancy leads to developmental abnormalities. Possible delay in growth and physical development, damage to the nervous system and a decrease in the baby’s ability to adapt after birth.

Under the influence of a lack of oxygen, metabolic processes in the embryo change. Blood circulation in the brain increases by reducing blood flow in the lungs, intestines, and kidneys. The resulting intestinal hypoxia leads to relaxation of the sphincter and the entry of original feces into the amniotic fluid. Dirty meconium water can enter the child's respiratory tract, leading to respiratory failure and pneumonia.

Although the fetus is quite sensitive to hypoxia, nature has endowed the unborn child with adaptation mechanisms that help the baby cope with oxygen starvation. Contained in red blood cells, fetal hemoglobin is different from adult hemoglobin and is more efficient at capturing and holding oxygen. And a high heart rate promotes more efficient distribution of precious gas.

Minor hypoxia does not cause negative consequences in the further development of the child. While severe oxygen deficiency is more dangerous, it leads to deep damage to organs with the development of necrosis in them. Therefore, the consequences of hypoxia vary from minor functional disorders to profound somatic disorders.

Possible consequences of acute fetal hypoxia:

• premature birth;
• damage to the child’s nervous system, cerebral palsy;
• antenatal fetal death;
• asphyxia, respiratory distress syndrome, pneumonia;
• intestinal necrosis.

Consequences of chronic intrauterine fetal hypoxia:

• developmental delay, low birth weight and height;
• anemia of the newborn;
• high susceptibility to infections;
• the baby’s inability to maintain normal temperature;
• neurological disorders.

If a lack of oxygen is detected, the woman is hospitalized in an obstetrics and gynecology hospital, where examination and treatment are carried out. An important link in the treatment of hypoxia is identifying the cause of the pathology.

If chronic hypoxia is detected, the following are prescribed:

1. Bed rest. A woman in a hospital must strictly adhere to the regimen prescribed by the doctor. This will help improve blood circulation and reduce increased uterine tone.
2. Oxygen therapy. Inhalation of oxygen or an oxygen-air mixture in the form of inhalations is effective in treating hypoxia.
3. Drugs that reduce uterine contractility. To prevent miscarriage and prevent premature birth, a woman is prescribed medications with antispasmodic activity: “Papaverine”, “No-shpa”, “Ginipral”, “Bricanil”.
4. Drugs that affect the rheological properties of blood. To improve blood delivery through the placenta by dilating blood vessels, as well as reducing its viscosity, the doctor may prescribe “Reopoliglyukin”, “Curantil”, “Trental”.
5. Means to improve metabolic processes in the fetus. This group of substances includes glucose, vitamins C, E, group B, Calcium gluconate, Glutamic acid.
6. Combating metabolic acidosis. Under the control of acid-base balance, it is possible to carry out infusions of “Sodium bicarbonate” of various concentrations.

The volume and duration of treatment for fetal hypoxia are determined individually in each case by a gynecologist.

Severe hypoxia is an indication for emergency delivery without waiting for the due date of birth. In this case, a caesarean section is performed. A child who has suffered acute hypoxia during childbirth may require resuscitation care to restore vital functions.

It is impossible to completely eliminate the risk of developing hypoxia, but the expectant mother should know what activities are most likely to help maintain the health of the child:

1. Pregnancy planning. A family should approach the decision to have a child responsibly. Parents should undergo preconception preparation, undergo a comprehensive examination, and treat chronic diseases and infections. This will protect the baby from intrauterine infection and keep the baby healthy.
2. Rejection of bad habits. It has been proven that children from mothers suffering from various types of addiction are susceptible to chronic hypoxia throughout pregnancy. Babies are at risk for developing diseases in newborns and have developmental delays. Even passive inhalation of tobacco smoke leads to spasm of placental vessels and the development of hypoxia in the fetus.
3. Daily walks. During a normal pregnancy, a woman should receive moderate physical activity every day. Quiet walks, which are best done in a park or in nature, have a beneficial effect on the health of mother and child.
4. Proper nutrition. A pregnant woman should pay attention to her daily diet. It is during this period that it is very important to eat healthy foods rich in all essential nutrients.
5. Medical assistance. A woman must register for pregnancy and undergo examinations on time. Modern diagnostic methods are absolutely harmless to the child and help to identify the disease in the early stages. Timely and adequate treatment of diseases in a pregnant woman will help avoid the development of hypoxia. At the first signs of a change in the condition of the fetus, a woman should seek help from a specialist.

Conclusion

Pregnancy is a wonderful and happy period in the life of an expectant mother. It is at this time that a woman should pay increased attention to her well-being and take care of the baby’s health.

Every year, more and more women hear the diagnosis of “intrauterine fetal hypoxia”, since the causes of the pathological condition are varied and include both the health of the pregnant woman and environmental conditions.

The expectant mother must be aware of the full degree of responsibility for the health of the baby. A woman should reconsider her lifestyle, get more rest and seek specialized help in a timely manner. Proper management of pregnancy and childbirth, adequate treatment of somatic diseases, significantly increase the chances of avoiding fetal hypoxia and its consequences.