Fetal hypoxia: consequences for the child

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

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

If the hypoxia is insignificant, the baby is quite able to cope with this condition with almost no consequences for itself, since the compensatory mechanisms, even for an unborn baby, are incredibly large. So, the crumb in advance is “stocked up” with oxygen, because the number of O2 molecules in his blood is much higher than in an adult’s blood, so when fasting occurs, he will be able to consume his own reserves for some time. In addition, the baby's adrenal glands quickly respond to the lack of oxygen, which immediately in response produce hormones that allow for some time to increase blood pressure, normalize heart rate.

Despite all this, unfortunately, these mechanisms are not able to compensate for prolonged hypoxia or acute fetal hypoxia. When the gynecologist, who observes the expectant mother, speaks about the presence of fetal hypoxia, he will definitely clarify the extent of the problem. Grade 1 - insignificant, the second and third may be grounds for hospitalization of a pregnant woman or premature delivery if the condition of the baby is threatening.

Acute hypoxia most often develops in the process of childbirth. It is provoked by the wrong actions of medical staff - stimulation of contractions with strong medicines, aggressive acceleration of the labor process.

Doctors can predict the possible consequences for the child already in the delivery room, since the state of the crumbs immediately after birth says a lot. Depending on him, he is given the first marks in his life - Apgar scores, this post-hypoxic assessment must be included in this rating system. The lower the score, the more serious the problem may be in the future. A child born with acute hypoxia is characterized by low grades in the first 10 minutes after birth, but within an hour, the child can easily be given 7-8 Apgar scores. In this case, the forecasts are positive. If the condition of the baby does not improve or starts to deteriorate, the forecasts are not so bright.

Chronic hypoxia can occur for several reasons:

• diabetes in the mother;
• viral infection, transferred in the first trimester of pregnancy;
• double or triple pregnancy;
• prolonged state of threatened abortion, threatening miscarriage;
• partial placental abruption, bloody discharge;
• postponed pregnancy (more than 40 weeks);
• anemia of the pregnant;
• impaired uteroplacental blood flow;
• bad habits - smoking during pregnancy, alcohol, drugs.

Acute hypoxia occurs in cases of complications during childbirth with:

• entwining the baby with the umbilical cord with pinching the umbilical ring;
• polyhydramnios;
• double-triple pregnancies;
• premature detachment of the placenta, which is often the case with fast, rapid delivery or at birth, which is stimulated by a puncture of the membranes of child or drug-induced;
• primary or secondary weakness of labor forces.

Diagnosing fetal hypoxia is not easy, as babies behave differently in the womb. One is lazy due to temperament and moves rarely, the other is active, and its frequent movements are often accepted by women and doctors for manifestation of hypoxia. Some symptoms should alert:

• a change in the nature of fetal motor activity, in which at first the baby moves chaotically and often with severe painful jolts, and then with the development of oxygen starvation, the movements become more and more rare;
• the height of the bottom of the uterus is significantly below normal;
• the child develops with a noticeable lag (fetometric indicators below the lower limit of the norm);
• a pregnant woman has a lack of water.

Normally awake baby must make up to 10 movements per hour. It can be coups, easily noticeable and discernible, and subtle movements. It is recommended to register movements from 20-22 weeks of pregnancy until its termination.

If a doctor has a suspicion of hypoxia based on the deviations described above, he will definitely prescribe a pregnant CTG. In the course of cardiotocography, sensors fixed on the abdomen will record all the movements of the baby, the change in the frequency of its heart contractions, even hiccups will be reflected. Additional methods of research include doplerometry, fetal ECG and ultrasound (this differs from the standard ultrasound procedure in that the doctor will not look at parts of the child’s body, but at the flow velocity in the uterine arteries, in the umbilical cord). An advanced blood test from the mother's vein on top of the listed methods allows you to determine if there is enough hemoglobin in the blood and to clarify other biochemical factors.

Bradycardia is considered to be the most reliable symptom - a decrease in the heart rate of the baby, which has not yet come to light. If the fetal heart rate is normal - from 120 to 170 beats per minute, then for a child who suffers from oxygen starvation, the heart rate will be at the level of 80-90 beats per minute. Tachycardia is also talking about the lack of oxygen, if the child’s heart rate is above 180-190 beats per minute.

Amniotic fluid, in which there was a child with chronic hypoxia, is sometimes dark or dark green in color, with an unpleasant smell of meconium (the original feces of the newborn). After the birth, the baby itself will be weaker than other babies, it will have reduced or increased muscle tone, neurological disorders of varying severity.

The most terrible, but, alas, absolutely real consequence of oxygen starvation is hypoxia of the brain. It is the brain that suffers from hypoxia more often and stronger than other organs. Predict what violations will cause dysfunction of a particular area of ​​the brain, in the perinatal period will not undertake even the most experienced doctor.However, after childbirth, it is quite possible to assess the traumatic impact. And if some violations, such as problems with speech development, will become apparent later, then gross 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 infancy.

Consequences for the nervous system due to brain cells dying during oxygen deficiency may be different - from moderate hyperactivity of the child in the future to severe lesions, which include cerebral palsy, paresis of various dislocations. In complicated childbirth in a state of acute hypoxia, hemorrhage in the brain, ischemia, and brain edema often occur. Lesions that occur with such violations can be total and irreversible.

Both acute and chronic oxygen deficiency can lead to a wide variety of diseases, predominantly neurological properties. So, problems with sight or hearing are quite common post-hypoxic consequences. If the hypoxia was prolonged, then the child may have underdevelopment or abnormal development of certain internal organs, heart defects, kidneys, and so on. Minor neurological disorders in most cases, the child can “outgrow” years to 6–7, of course, with constant monitoring by a neurologist and the implementation of all his recommendations.

The established fact of hypoxia during pregnancy in no case should not be ignored, you need fast and effective therapy to minimize the possible consequences for the baby. Doctors call future mothers, in the first place, to calm down, because excessive nervous experiences only aggravate the already rather complicated state of the child.

In late periods, severe hypoxia can be an indication for urgent delivery by cesarean section. In earlier periods, when the baby is still quite early to be born, doctors will try to do everything possible to make the baby better. Treatment can take place at home, but on condition that the severity of hypoxia does not exceed 1 degree. The remaining cases are subject to urgent hospitalization and constant monitoring of the pregnant woman and the baby in the hospital.

Doctors prescribe mothers for bed rest, it is with him that the blood supply to the placenta increases and minor hypoxia can be cured as soon as possible. The main approach to drug therapy is the use of drugs that improve uteroplacental blood flow, such as "Curantil", "Actovegin". In severe hypoxia, these drugs are administered intravenously by drip. In other situations, it is allowed to take pills. A woman is prescribed vitamins, iron and magnesium preparations. The courses of treatment are repeated.

Two specialists take part in this - an obstetrician-gynecologist who knows what his patient can and cannot do in an “interesting” position, and the specialist doctor who is in charge of the disease. They must prescribe medications and manipulations together, the treatment as it was before the onset of pregnancy, as a rule, is changing.

All children, without exception, who experienced hypoxia during their prenatal existence, are shown special observation by a pediatric neurologist. Almost always these kids, regardless of the consequences, put on dispensary accounting. They, in most cases, recommended therapeutic massage from the very first days, taking vitamins, water treatments using soothing decoctions of herbs. Many babies after 3-4 years old need to have a speech therapist to overcome possible problems with speech development and pronunciation.

The rest of the treatment depends only on what post-hypoxic diagnosis was made, because with cerebral palsy one approach and the choice of drugs is required, and with the pathological hearing or vision loss it is completely different. Cerebral palsy is considered to be the most severe in the treatment, and the increased muscle tone without other neurological symptoms is most easily corrected. Parents should prepare for fairly long-term treatment, since the post-hypoxic effects that need to be corrected have to be eliminated for years.

You can find out some more information about hypoxia in the following video.