Hypoxia of the child in the womb. Causes, symptoms and treatment of oxygen starvation of the fetus during pregnancy

Oxygen starvation fetus during pregnancy is a fairly common complication that can occur at any stage of gestation. The pathological process as a result of which the supply of oxygen is disrupted threatens the child’s life and affects physical and mental development.

Oxygen starvation of the fetus: symptoms

Suspicion of lack of oxygen early stages pregnancy occurs when anemia is detected. A lack of hemoglobin in the bloodstream affects the child's breathing. Iron supplements are prescribed to restore these blood cells.

Later, at 16–18 weeks, when the mother feels the baby moving, oxygen starvation of the fetus during pregnancy can be determined by increased motor activity or, conversely, too low. It is necessary to notice such symptoms and promptly consult a doctor for further diagnosis.

Signs that you should pay attention to during instrumental examinations:

1. Ultrasound measures the weight, height and volumetric parameters of the baby. In case of significant deviations from the norm, prescribe additional research, to confirm the diagnosis and prescribe treatment.
2. Doppler testing helps determine impaired blood flow in the mother-placenta-fetus arteries. A slow heartbeat (bradycardia) indicates a long-term pathology when the embryo has exhausted its resources to provide internal organs.
3. Amnioscopy reveals meconium impurities in the amniotic fluid.

During the examination, the doctor listens heartbeat, bradycardia or tachycardia become a reason for prescribing additional tests. In later stages, a lack of oxygen is also determined by a decrease in the baby’s movements.

Causes of oxygen starvation of the fetus during pregnancy

There are two types of oxygen starvation - chronic and acute. With prolonged hypoxia, the baby long time feels a lack of substance, so it is important to promptly identify the pathological process in order to avoid developmental delays.

The acute type of pathology is characterized by a sudden appearance, often in the process labor activity.

The reasons for the formation may be related to both the health of the expectant mother and the presentation of the embryo:

• reduced amount of hemoglobin in the blood – anemia;
• arterial hypertension;
• diseases that cause difficulty breathing - bronchitis, asthma or allergies caused by a runny nose;
• heart disease and vascular pathologies;
• chronic diseases - diabetes, renal failure;
• genitourinary infections;
• conceiving more than one fetus;
• bad habits – smoking, alcohol abuse;
• increased or decreased content of amniotic fluid.

The incorrect position of the baby inside the womb is caused by entanglement of the umbilical cord, which can cause pressure and decreased blood circulation. Post-term and long-term difficult birth can cause hypoxia. At this stage, it is important that doctors provide timely emergency assistance, prevented suffocation and saved the life of the newborn.

Why is fetal oxygen deprivation dangerous?

The initial onset of hypoxia is characterized by a rapid heartbeat, as the body activates compensatory capabilities. Thus, blood flow is normalized in order to supply oxygen to vital organs.

The consequences depend on the timing and duration of the process in the embryo. In the first trimester, lack of oxygen causes developmental delays.
The formation of internal organs and the brain occurs with a delay. Developmental delay is most dangerous for the central nervous system, decreasing protective properties baby, there is a risk of developing birth defects.

A chronic type of pathology impairs blood circulation, vascular permeability increases, and the blood becomes thicker, which threatens thrombus formation.

An acute lack of oxygen during labor can be fatal. Children are born weak, with serious neurological pathologies in the future.

Timely treatment and assistance from doctors is the main factor in restoring the infant’s respiratory function.

How to treat oxygen starvation of the fetus during pregnancy?

For fetal hypoxia, treatment involves not only taking medications, but also a change in a woman’s lifestyle. Bed rest, walks fresh air, nutritional adjustments, rational changes in sleep and activity should become the main basis during the period of bearing a baby.

Diagnosis of severe hypoxia must be treated in a hospital setting to ensure complete rest. First of all, specialists try to identify the cause of the pathology, which will help prescribe medications more specifically.

When found high blood pressure use medications with the effect of stabilizing blood pressure. Therapy infectious diseases based on anti-inflammatory and antibacterial agents.

• decreased uterine tone;
• blood thinning;
• restoration of blood flow;
• improvement of metabolism;
• increasing the permeability of blood vessels and tissue cells.

If by the 30th week, after a course of therapeutic actions, there is no improvement, a decision is made on emergency delivery by caesarean section.

For warning purposes pathological process, it is recommended to plan conception and undergo examinations for the presence of infectious diseases. When forming chronic disease the expectant mother, it is necessary to consult with specialists and adhere to the advice of doctors.

When a woman finds out about her pregnancy, her life begins to proceed according to new rules. She strictly forbids herself from abusing store-bought delicacies saturated with “chemicals”, and closely monitors her health.

Relatives and friends in her company are not allowed to smoke or even raise their voices, otherwise “the little one gets scared.” And, although this can sometimes infuriate one of the relatives, all this is correct - the maternal instinct turns on.

A woman must endure and give birth without difficulty - and for this it is important that the processes in her and the baby’s bodies proceed without failures. If something goes wrong, it first of all hits the small ones, ending, say, with hypoxia. Have you been diagnosed with this? This is a serious matter - action needs to be taken!

What is fetal hypoxia?

With hypoxia, the baby suffocates, that is, there are problems with the “supply” of oxygen from the mother’s body. Doctors call this condition of the baby oxygen starvation. It comes in two types: acute (occurs during childbirth) and chronic (if it begins in the mother’s belly).

So, there is not enough oxygen. Abnormalities appear in the tiny body. If hypoxia is seen and treated in time, it is not scary, but if not, the changes will be irreversible.

Hypoxia at the beginning of pregnancy, when all the systems and organs of the embryo have just begun to form, threatens to develop into abnormal development (less often, into injury). Appearing towards the end of pregnancy, the lack of oxygen hits physical development toddler (growth inhibition, mental and physical deviations), as well as in the central nervous system.

If oxygen starvation began during childbirth, the baby’s muscles will be hypertonic, he will have problems with sleep, appetite, constant bad “mood” - in general, disorders of the autonomic nervous system. Such a baby is a typical patient of a neurologist.

How is everything going?

All systems and organs of a “starving” baby are on high alert, trying to get more oxygen. But since the baby cannot look out of the belly and breathe full breasts, he has to include compensatory capabilities (that is, roughly speaking, what fully goes to one organ is completely or partially taken away from another). From the outside it seems that the baby is simply “nervous” or “playing”, that is, fidgeting all the time - but this is for the time being.

Over time, depression sets in in the little body - since the “hungry” baby is no longer able to move, it subsides. This is a bad sign that will lead to more severe consequences. This is why many gynecologists warn expectant mothers: if the “belly” pushes for a long time and often, and then suddenly becomes suspiciously quiet (3 movements in an hour, or even less), go to the gynecologist, and as soon as possible! He may refer you to Doppler or - and do not skip these examinations, they are better than others in identifying oxygen starvation of the fetus.

What causes hypoxia?

Yes, the list of diseases published above makes it clear that clean air and an iron-rich diet alone are not enough - but still healthy image life greatly increases your chances that you will never hear about hypoxia in your “interesting position.”

Finally, do not miss visits to the residential complex - if you were destined to fight some kind of disease, then the sooner it is detected, the easier it will be to defeat it.

Acute fetal hypoxia

Problems that arise during childbirth are isolated case, which is worth talking about in more detail. In this case, there are also enough reasons for hypoxia:

• entwining the baby's neck with the umbilical cord;
• prolonged or very rapid labor, when the baby is pinched in the birth canal and cannot breathe;
• premature placental abruption.

Any of these cases causes suffocation (scientifically - asphyxia).

Having seen that the baby has begun to lack oxygen, your obstetrician will closely monitor the baby (for example, he will conduct cardiac monitoring, listening to his heart). Even the color of the water can alert the doctor: if it is green and cloudy, the matter is “unclean” - a lot of meconium has got into it. Also, doctors will not like the “wrong” pH level in the baby’s blood and fetal fluid.

If labor is in progress and hypoxia is only increasing, the doctor will stop you and urgently take you to an emergency procedure.

Important point! Very often, acute hypoxia is a consequence of problems during pregnancy. That is, if you take care all 9 months before giving birth, or if all your diseases are diagnosed and treated on time, you will have many chances to give birth normally, without oxygen starvation and cesarean section.

Fetal hypoxia– disruption of the vital functions of the fetus, developing due to lack of oxygen during pregnancy and childbirth.

As a rule, oxygen deficiency occurs during the period and is associated with different problems. The most common of them are chronic diseases of the mother.

Fetal hypoxia develops under the influence of many disorders of the process and pregnancy.

Slight hypoxia will not affect the life and health of the fetus in any way. However in severe cases of the disease, which is accompanied by ischemia and necrosis of internal organs, there are irreversible consequences for the health of the fetus.

Oxygen starvation of the fetus occurs due to various processes in the mother, fetus or placenta. Hypoxia can be chronic or acute.

Acute hypoxia develops suddenly, and chronic - within long period time. Acute hypoxia, as a rule, occurs already during childbirth, and is extremely rare during pregnancy.

Chronic it can develop throughout pregnancy.

Symptoms

Hypoxia can be diagnosed by a rapid heartbeat in the early stages of pregnancy and a slow heartbeat in the later stages. In addition, heart sounds are muffled.

Besides original fetal feces appear which is called meconium, in amniotic fluid.

If a pregnant woman experiences light form fetal hypoxia, then she can feel that the baby has begun to move much more actively.

In case of severe on the contrary, his movements become slower and occur less frequently.

So, if you suspect that you have this disease, then keep a movement diary.

If their frequency is less than 10 per hour, then you should contact your gynecologist to prescribe further tests.

Signs

Detection of fetal hypoxia is almost impossible. However, it can be suspected based on maternal anemia or other medical conditions.

Mid pregnancy When the baby's movements are most active, hypoxia can be suspected if their frequency decreases. If your movements become more sluggish or infrequent, contact your healthcare provider.

Besides own feelings, the diagnosis of fetal hypoxia can be made based on examinations:

1. If, according to the results of an ultrasound examination, the size and weight of the fetus less than normal, and there is also a delay in its development.
2. If Doppler ultrasound shows poor blood flow in the placenta, uterine arteries or there is a suspicion of a reduced fetal heart rate.
3. In the third trimester of pregnancy, the condition of the fetus is assessed as 8 or lower. However, this indicator often shows hypoxia when there is none. So if you suspect this disease, you should redo the test after a few days.
4. In some cases, amnioscopy is performed and blood is taken from the skin of the baby’s head during childbirth.
5. The presence of fetal hypoxia during childbirth can be indicated by the color of the amniotic fluid. In this case, they become cloudy green in color, in some cases containing meconium. There is no fetal hypoxia during childbirth if the waters break clear.

Causes

Hypoxia is not an independent disease, these are consequences of various factors. These factors can come from the mother, the fetus, or the abnormal course of pregnancy.

Reasons chronic hypoxia mother's side most often are:

• kidney disease or toxic damage;
• pregnant;
• intoxication;
• diseases of the cardiovascular system or lungs;
• maternal smoking during pregnancy;
• unfavorable working conditions.

Among the main complications course of pregnancy, which causes hypoxia, we can highlight:

• gestosis;
• or ;
• insufficient uteroplacental blood flow;
• diseases of the placenta;
• incorrect presentation of the fetus;
• pregnancy.

Chronic hypoxia can also be caused by diseases of the fetus itself. The most common of them:

• hemolytic disease, especially in severe form;
• congenital malformations;
• fetal anemia;
• infections.

The causes of acute hypoxia are:

• placental abruption;
• rapid labor;
• compression of the head during childbirth;
• pain relief given to a woman in labor during childbirth;
• weak labor activity.

Forms of the disease

Fetal hypoxia may be acute, subacute and chronic.

Acute hypoxia may occur during pregnancy or childbirth. In the first case, it occurs due to uterine rupture or premature detachment placenta. In the second - with abnormal labor or clamping of the umbilical cord.

Subacute hypoxia occurs a few days before birth.

Chronic hypoxia occurs when there is a complication of pregnancy or illness of the mother or fetus. Due to a long-term lack of nutrients and oxygen, as a rule, there is a delay in fetal development and insufficient fetal size.

The danger of hypoxia for the fetus and its consequences

On different dates During pregnancy, fetal hypoxia can cause various disorders and pathologies of fetal development.

In the first trimester During the formation of the fetus and its internal organs, hypoxia can cause pathologies in fetal development.

In late pregnancy due to oxygen starvation, the fetus may have developmental delays, insufficient size and weight, as well as damage to the central nervous system.

Hypoxia during childbirth can cause fetal asphyxia and severe disorders of the central nervous system. That is why, if hypoxia occurs during childbirth, it is recommended to carry out.

Diagnosis and treatment of the disease

In case of acute oxygen deprivation The fetus must undergo an emergency cesarean section during labor. When the cervix is ​​dilated, forceps are applied.

If we are talking about chronic hypoxia that occurred during pregnancy, then during childbirth the mother is administered glucose, ascorbic acid and antispasmodics, as well as oxygen therapy.

For chronic fetal hypoxia, some doctors recommend do not treat this condition, but monitor the condition of the fetus. In this case, if the situation worsens significantly, an emergency caesarean section should be performed.

• prescribed to a pregnant woman bed rest which improves blood circulation in the uterine cavity;
• Prescribe drugs that improve metabolism, capillary blood supply, as well as placental blood flow. In addition, it is necessary to use drugs that increase cell permeability to oxygen;
• treatment of diseases that caused hypoxia;
• drugs that reduce uterine contractions;
• if the fetal condition worsens, a caesarean section should be performed after the 28th week.

Disease prevention

A pregnant woman and her doctor should monitor the course of her pregnancy very closely. Thus, it will be possible to determine fetal hypoxia as early as possible.

Oxygen starvation of the fetus occurs due to diseases of the pregnant woman or fetus. So the most important thing is to early diagnosis pregnant woman and fetus.

Besides it is important that the expectant mother not only during pregnancy, but also before it, I monitored my health, nutrition, led a healthy lifestyle and experienced sufficient physical exercise.

Throughout pregnancy, a woman should walk outdoors as much as possible. This rule will allow the pregnant woman not only to prevent certain possible complications pregnancy, including oxygen starvation of the fetus.

Supply of oxygen to the body ensures better metabolism in the placenta and reduces the likelihood of oxygen starvation of the fetus.

In addition to prevention with the help of walks in the fresh air you can treat and mild degree fetal hypoxia. Because no oxygen cocktails can replace several hours in the fresh air.

If the expectant mother does not have or, then It’s worth doing swimming or aqua gymnastics.

Fetal hypoxia may appear in different terms intrauterine development and are characterized by varying degrees of oxygen deficiency and consequences for the child’s body. Developed in the early stages of pregnancy, it causes defects and slow development of the embryo. In the later stages, it is accompanied by fetal growth retardation, damage to the central nervous system and a decrease in the adaptive capabilities of the newborn baby.

The fetus's lungs are not yet working; oxygen is supplied to it through the placenta, which in turn receives it from the woman's body. If this process is disrupted, fetal hypoxia develops. In this regard, there are two main types of hypoxia:

Chronic hypoxia appears during pregnancy and can develop over a long period of time.

Acute hypoxia can occur during difficult labor.

What is the danger of fetal hypoxia

Minor hypoxia usually does not affect the child’s health, but in severe form, oxygen deficiency can lead to quite dangerous disruptions in the functioning of the fetus’s body. The degree of danger depends on the period of its occurrence.

On early stages During pregnancy, a lack of oxygen leads to a slowdown in the child’s development and the appearance of various anomalies. Already from 6–11 weeks of pregnancy, hypoxia can disrupt the maturation of embryonic brain structures, slow down the maturation of the central nervous system and the functioning of blood vessels. All this jeopardizes the normal functioning of the child’s brain.

IN late dates hypoxia leads to a delay in the baby’s development, growth, and affects him nervous system and reduces adaptive abilities in the postpartum period. A child born in conditions of hypoxia may be at risk of various neurological disorders - from minor ones (restless sleep, poor appetite, whims, convulsions) to severe disorders mental development and serious somatic abnormalities.

Acute fetal hypoxia can cause premature birth, weakness of labor and even the death of the child.

In addition, hypoxia during childbirth is fraught with asphyxia - the inability of the newborn to take its first breath. In some cases, such children may need artificial ventilation lungs.

Causes of fetal hypoxia

Intrauterine fetal hypoxia may be justified for various reasons. This is, as a rule, a consequence of abnormalities in the body of the woman herself, the fetus or the placenta, through which oxygen flows to the child.

Pathologies of the mother that can cause hypoxia:

• Bad habits. Smoking (including passive smoking) is especially dangerous, since nicotine constricts blood vessels, which means that blood circulation in the pregnant woman’s body is impaired.
• Anemia – low hemoglobin. When it occurs, the delivery of oxygen to the tissues of the body is disrupted. Anemia has three degrees of severity, and the severity depends on this possible deviations The child has.
• Diseases of the cardiovascular system(congenital or acquired heart disease, myocardial infarction, hypertonic disease). They cause vascular spasms, which impairs blood supply to the fetus.
• Bronchial asthma, emphysema, chronic bronchitis and other organ diseases respiratory system. They cause respiratory failure, as a result of which hypoxia develops in the woman herself, and therefore in her baby.
• Kidney diseases(chronic renal failure, amyloidosis, etc.).
• Diabetes and other abnormalities in the functioning of the endocrine system.
• Preeclampsia(late severe toxicosis).
• Frequent stress.

Fetal diseases causing hypoxia:

• Congenital malformations.
• Intrauterine infections (herpetic infection, toxoplasmosis, chlamydia, mycoplasmosis and others).
• Hemolytic disease – incompatibility of the blood type of mother and child, as a result of which the woman’s body considers the fetus foreign body and tries to tear him away.

Directly during childbirth, hypoxia can occur for the following reasons:

• Incorrect presentation of the fetus (breech or oblique).
• Prolonged compression of the head in the birth canal.
• Multiple births.
• Post-term pregnancy.
• Umbilical cord prolapse.
• Repeated and tight entanglement of the child with the umbilical cord.
• Placental abruption.
• Weak labor.
• Discrepancy between the width of the woman’s birth canal and the size of the child.

Diagnosis of hypoxia: independent and medical

In the early stages oxygen deficiency the fetus is almost impossible to detect. It can only be assumed by anemia and other diseases of a pregnant woman.

Starting from 18–20 weeks, intrauterine fetal hypoxia can be detected independently. It is manifested by changes in the child’s motor activity. At first, his restlessness and increased movements are noted, then, with a longer lack of oxygen, movements, on the contrary, suspiciously weaken, become sluggish and more rare. Therefore, it is important to monitor your baby’s activity daily. There is a so-called method 10. From the very morning, watch the baby’s movements. In 12 hours there should be 10 or more. This does not mean every single movement, but episodes of activity. Typically they last 1–2 minutes. If there is less movement, you should immediately consult a doctor.

Modern examination methods help determine whether the fetus is suffering from a lack of oxygen or not. The most important of them are the following:

• Auscultation– listening to the baby’s heartbeat using a stethoscope. The doctor evaluates the heart rate, rhythm, presence of murmurs, and heart sounds. At the initial stage, the fetal heartbeat quickens and sounds are muffled. With prolonged oxygen starvation, the fetal heartbeat slows down.
• Cardiotocography (CTG)– a method of diagnosing the condition of the fetus using a cardiac monitor, which shows an analysis of the fetal heart rate and its motor activity. CTG is performed from 30–32 weeks of pregnancy and can also record uterine contractions. CTG is also done directly during childbirth, since disturbances in the child’s cardiac activity are the main indicator of hypoxia.
• Ultrasound examination(ultrasound)– fixes possible delays in the development of the fetus, analyzes its height, size and weight in accordance with the norms. In addition, ultrasound examines amniotic fluid, its volume, composition and color, as well as the presence of oligohydramnios or polyhydramnios, which can cause hypoxia.
• Doppler– studies the nature of blood flow in the vessels of the placenta and umbilical cord, disruption of which may be a sign of oxygen deficiency.
• Amnioscopy– inspection amniotic sac using an endoscopic device inserted into the cervical canal. Used to study the state of amniotic fluid. Fetal hypoxia is indicated by the presence of meconium in the amniotic fluid and its greenish color.

Immediately after birth, the doctor can easily determine the presence of hypoxia in a newly born baby. The presence of oxygen starvation in this case will be indicated by:

• Pale, bluish skin color.
• Labored breathing.
• Weak screaming and no crying.
• Weak muscle tone.
• Weak reflexes.
• Low heart rate.

Such a child often requires resuscitation care.

How is intrauterine fetal hypoxia treated?

Hypoxia does not appear suddenly; regular visits to the doctor managing the pregnancy can prevent or minimize it. It is important that pregnancy management is carried out taking into account risk factors and timely monitoring of the condition of the fetus and woman.

The main task of the doctor is, first of all, in the early stages of pregnancy (and ideally when planning it) to eliminate all causes that can cause hypoxia. If hypoxia has already been detected, the pregnant woman may be treated in a hospital or at home, if her condition allows. The most important condition in this case, giving her complete rest and taking medications in a timely manner.

The main thing that treatment of hypoxia should be aimed at is restoring normal blood supply to the fetus. To do this, the expectant mother is prescribed bed rest, with a preferential position on the left side (this promotes better blood supply to the uterus) and medications that improve blood flow to the placenta and normalize metabolism between mother and child, as well as treatment of underlying diseases that can cause hypoxia to appear.

For mild hypoxia, the following are most often prescribed:

• Oxygen inhalations.
• Glucose with ascorbic acid and insulin.
• Inhalation with alkaline solutions (for example, a solution baking soda with water or alkaline mineral water).
• Sessions in a pressure chamber.

During hypoxia, physical activity is very useful for pregnant women. However, if you did not exercise before pregnancy, you should not suddenly rush to exercise equipment. Consult your doctor and, if there are no contraindications to activity, choose a moderate load for yourself. Yoga, Pilates, swimming, water aerobics are suitable - all these sports improve blood circulation throughout the body, including the placenta, which increases the amount of oxygen supplied to the baby. It is better to attend classes with an instructor who will closely monitor you, taking into account the stage of pregnancy and the corresponding condition.

Prevention of intrauterine fetal hypoxia

Preventing the development of fetal hypoxia requires a woman to prepare responsibly for pregnancy. Refusal bad habits, proper nutrition, treatment of diseases of the reproductive system and existing chronic diseases even at the stage of pregnancy planning can minimize the risks of hypoxia.

It is recommended to prevent hypoxia from the very beginning of pregnancy. Future mom should give up bad habits, lead a healthy lifestyle, avoid overwork, but the most important thing is to walk as much as possible (if once a day, then at least 2 hours, but if such long walks are not possible, then you can walk little by little for 2–2 hours). 3 times a day). A walk (ideally outside the city) stimulates the entire body, but has a particularly positive effect on the respiratory and cardiovascular system. Inhaled air improves metabolism in the placenta and reduces the likelihood of hypoxia. In addition to walking, do not forget to regularly ventilate your apartment.

Also, to prevent hypoxia, it is very important to monitor iron levels and possible occurrence anemia. To do this, you need to eat right (include iron-containing foods in your diet: beef, buckwheat, etc.) and take the necessary medications and vitamins as prescribed by your doctor.

To prevent the development of acute fetal hypoxia, it is important to choose the right method of delivery. If the pregnancy is more than 28 weeks, the doctor may prescribe an emergency birth by cesarean section. In addition, childbirth takes place with mandatory cardiac monitoring, which allows you to monitor the child’s condition and, if necessary, change the delivery tactics.

A baby born with hypoxia may need resuscitation care. In the future, children who have developed under conditions of hypoxia should be especially carefully observed by a neurologist, who will prescribe a course of treatment for them. physical therapy, massage, sedatives, etc.

The main thing is to remember: your health is the health of your unborn child. Take care of yourself and carefully monitor your condition and the condition of the baby growing inside you!

Vulnerabilities

The nervous system is one of the most oxygen-dependent, and if the growing fetus lacks oxygen, it primarily affects the nervous tissue. At the same time, while the child’s body intensively supplies the nervous system and heart with oxygen, other organs suffer - the lungs, gastrointestinal tract, skin etc. Therefore, with prolonged hypoxia, pathologies of almost all fetal organs are possible.