What happens when there is a lack of oxygen
Oxygen reaches the baby through the placenta and umbilical cord. When it becomes less, the fetus’s body turns on protection: it slows down growth, redistributes blood in favor of the brain, heart and adrenal glands, and changes the heart rate. The doctor sees these changes with Doppler measurements and CTG before noticeable symptoms appear. If the deficiency increases, compensatory capabilities are exhausted, tissues suffer, and a threat to the child’s health arises. That is why it is important not to wait for obvious signs, but to be observed according to the prescribed schedule.
- Chronic hypoxia - develops gradually
- Acute hypoxia - occurs suddenly
- Redistribution of blood flow to the brain
- Change in heart rate
- Slow growth due to prolonged lack of oxygen
- Signs are visible with Doppler and CTG before complaints
Reasons
On the maternal side, the causes include severe anemia, heart and lung diseases, arterial hypertension and preeclampsia, diabetes mellitus, and smoking. From the placenta and umbilical cord - placental insufficiency, premature detachment, true nodes and compression of the umbilical cord, its prolapse during childbirth. On the part of the child - intrauterine infection, hemolytic disease due to Rh conflict, developmental defects. Separately, situations during childbirth are distinguished: excessively frequent and strong contractions, a long anhydrous period, post-term pregnancy.
- Anemia and chronic maternal diseases
- Preeclampsia and hypertension
- Smoking
- Placental insufficiency and placental abruption
- Compression or prolapse of the umbilical cord
- Intrauterine infection and Rh conflict
- Complications of childbirth and post-term pregnancy
How to suspect
There are no reliable sensations by which a woman could make a diagnosis herself, but one guideline works well - movements. Each child has his own usual rhythm of activity, and it is the deviation from it that is important: a noticeable decrease in movements, their weakening, or, conversely, a period of unusually vigorous activity followed by a lull. During the examination, the doctor evaluates the heartbeat, the height of the uterine fundus and weight gain. Indirect signs are oligohydramnios, retarded fetal growth and greenish amniotic fluid when it is released.
- Changing the usual pattern of movements
- Reducing the number of movements
- Fetal growth retardation on ultrasound
- Low water
- Changes in heart rate when listening
- Greenish amniotic fluid
What examinations are needed
The main method for assessing the condition of the child in the third trimester and during labor is cardiotocography, which records the fetal heartbeat and its reaction to movements and contractions. It is complemented by ultrasound with measurement of the amount of amniotic fluid and assessment of growth. Doppler ultrasound shows blood flow in the uterine arteries, umbilical artery and middle cerebral artery of the fetus, allowing you to understand whether there is a redistribution of blood flow. The frequency of studies is determined by the doctor based on the cause and severity of the condition. If necessary, use an extended assessment of the biophysical profile of the fetus.
- Cardiotocography
- Ultrasound with assessment of growth and amount of water
- Doppler ultrasound of umbilical cord vessels
- Assessment of fetal cerebral blood flow
- Biophysical profile of the fetus
- Counting the movements of the woman herself
What do doctors do
Treatment is aimed at the cause: correction of anemia, control of blood pressure and preeclampsia, treatment of infection, compensation for diabetes, complete smoking cessation. There are no magic drugs that saturate a child with oxygen, and common schemes with dubious means do not replace observation. In case of chronic hypoxia, the basis remains frequent monitoring of CTG and Doppler measurements and timely delivery if the child’s condition worsens. Acute hypoxia is an indication for emergency surgery. If there is a sudden change in movements, you should immediately go to the maternity hospital or call 103.
- Treatment of anemia and maternal diseases
- Controlling blood pressure and preeclampsia
- Complete smoking cessation
- Frequent monitoring of CTG and Doppler measurements
- Hospitalization if indicators worsen
- Early delivery according to indications
- Emergency caesarean section for acute hypoxia
