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Fetal hypoxia: what is it and what does it depend on

Fetal hypoxia: what is it and what does it depend on

The future baby receives oxygen and nutrients from my mother’s blood through the umbilical cord, which connects to the placenta, and that in turn is attached to the wall of the uterus. In order for the “supplies” to be uninterrupted, each link in this chain must properly perform its function.

Failure at any of the stages can lead to difficulties.

Impaired blood flow in the uterus leads to disruption of the blood supply to the placenta, which causes the baby to receive less oxygen. The reason for this may be, for example, increased muscle tone of the uterus.

She, like any muscular organ, can shrink throughout the pregnancy, but the expectant mother feels it only with the approach of labor. If the muscles freeze in tension, “forgetting” to relax in time (for example, due to the pressure of excess amniotic fluid during high water), the blood vessels constrict and the blood flow in them slows down – which affects the supply of the placenta, and with it the baby.

That is why this situation always attracts the attention of obstetricians, because “unauthorized” contractions of a tense uterus can threaten pregnancy.

To reduce the tone of the uterus and put oxygen to the baby, doctors may prescribe medications for relieving muscle spasm, antispasmodics; relaxing uterus muscles and suppressing its contractile activity – tocolytics. And sometimes the situation can be solved by taking sedatives (sedatives) or vitamin-mineral preparations (for example, magnesium).

A great deal in the well-being of pregnancy depends on the state of the endometrium of the uterine mucosa. If his condition is influenced by inflammatory processes, infections (especially viral), curettage, the quality of the mucous membrane deteriorates and the blood vessels in it become smaller. At the conception stage, this can be manifested by the fact that the fertilized egg cannot properly attach itself to the wall of the uterus – like a seed that can take root only in loose fertile soil.

And with the onset of pregnancy, the thinned mucous will not provide normal conditions for the placenta. As a result, it may be worse supplied with blood and transfer less oxygen to the baby.

The baby seat, as the placenta is also called, is the most important battery that provides the baby with everything necessary for life. Violations in the structure and functioning of the placenta (placental insufficiency) or premature detachment of this organ inevitably lead to a decrease in blood flow in its vessels and impede the metabolism.

The same happens in a situation where the placenta is incorrectly attached (in the lower part of the uterus, near the cervix) or is aging prematurely (before the 32nd week). In the latter case, its structure changes, the vessels narrow, the proportion of connective tissue increases, the blood supply decreases, and hypoxia in the unborn child becomes the result.

The umbilical cord connects the placenta and the unborn child. Inside it passes a vein through which blood, rich in oxygen and nutrients, flows from mother to baby, and two arteries that bring the blood out of the baby’s body, saturated with carbon dioxide and metabolic products.

Any pathology of the umbilical cord may impede the flow of blood to the unborn child. Its size is too large (more than 70 cm) or small (less than 40 cm), due to excessive length of the nodes, underdevelopment of the umbilical cord, improper attachment (not to the placenta, but to the fetal membranes), the absence of one of the arteries – it all turns the deterioration of the “supply”.

A temporary interruption of oxygen can also occur for purely mechanical reasons – if the crumb, moving in her mother’s stomach, held out the umbilical cord, or the woman herself accidentally made it, having turned badly. The baby immediately signals its problem with displeased movements, and often, if the mother stands on the other side, everything returns to normal.

But the situation that future parents are most afraid of – the entanglement of the umbilical cord around the neck – rarely leads to problems during pregnancy. Negative entanglement does not affect the well-being of the baby, but if it persists until childbirth, it can be an indication for cesarean section.

Otherwise there is a risk that during movement along the birth canal the umbilical cord will be delayed.

Fetal hypoxia: what is it and what does it depend on

Whatever the causes of oxygen starvation in a baby, this situation requires immediate treatment. Acute hypoxia threatens to turn into asphyxia – stopping breathing, but chronic hypoxia affects the well-being of the little man.

The longer it lasts, the worse its consequences. Due to the lack of “life gas” all organs and systems, without exception, suffer, but above all – the brain. Its cells are particularly sensitive to oxygen deficiency.

Given that the brain is the main link of the central nervous system responsible for the development of a child, it becomes clear why children who have underwent intrauterine hypoxia often face neurological problems: for example, slower development of motor skills, convulsive states, disorders of muscle tone, etc.

Insufficient oxygen supply can occur at any stage of pregnancy. However, women usually hear the diagnosis of fetal hypoxia in the II – III trimesters, when doctors can identify this condition.

And approximately from the 18th week, when mom starts feeling the crumbs, she herself becomes the main diagnostician. After all, if the baby does not have enough oxygen, the nature of its movements changes: in order to activate the blood flow and thus compensate for the lack of air, it begins to move more vigorously. Shocks can be so violent, and sometimes painful, that sometimes deprive a woman of sleep and rest.

When the child doesn’t have enough forces for active movements, he calms down – then the mother feels that the movements have become rare and barely noticeable. That is why any sudden changes in the motor activity of the baby is a reason to immediately consult a doctor.

Specialists can even detect hypoxia without special devices using a simple obstetric tube. With a lack of oxygen, the nature of the child’s heartbeat changes: his rhythm becomes more frequent or, on the contrary, slows down. This is easily heard by the doctor, putting the stethoscope to the woman’s stomach.

But in order to accurately establish the degree and causes of the problem, one cannot do without technology.

For the diagnosis, obstetricians use cardiotocography (CTG), which evaluates the baby’s heartbeat and uterine contractions, and Dopplerometry, which can be used to measure the blood flow velocity in the uterus, placenta, umbilical cord and brain of the child. In recent years, in many clinics it has been possible to rent a portable CTG apparatus, which is important primarily for women with poor outcomes of previous pregnancies.

With the help of such a device, the expectant mother daily measure the child’s heartbeat and report the data to the doctor.

Ultrasound remains an indispensable diagnostic method. If the first two methods reveal the effects of hypoxia, then only an ultrasound can determine its cause, such as placental abruption or cord entanglement.

The main question that doctors must solve with the help of diagnostics is whether it is possible to prolong the pregnancy, by what methods, when and how the baby will be born.

Doctors do not treat the consequences, but the cause of hypoxia. And because in each case, the treatment will be special.

If the lack of oxygen has arisen due to an infection that the mother has encountered, then antiviral or antibacterial drugs will be required. With increased uterine tone, doctors will prescribe, for example, a means of relieving spasm.

With placental insufficiency will increase the nutrition of the uterus, including with the help of special vitamin preparations.

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