The placenta is responsible for the transfer of food and oxygen from the mother to the fetus. Thanks to her, two complex vascular systems are combined. One of them connects the placenta with the uterine arteries, and the other with the umbilical cord. In this case, the placenta serves as a barrier that protects the baby from viruses and harmful substances. It happens that when conducting an ultrasound, there is a violation of blood flow during pregnancy, which can affect the development of the baby.
Dopplerometry
Such an unusual name has a diagnostic procedure that identifies any pathology of blood flow in arteries and veins. As a result, a dopplerogram is built on specialized equipment, which displays the frequency difference between the sent and reflected signals. The study is conducted in standard mode or with color mapping, that is, the movement of blood through the arteries is displayed in color. The latter option allows you to quickly and accurately detect even a mild violation of the uteroplacental blood flow.
Dopplerometry is performed lying on your back or side. At the same time, a more truthful result can be obtained on the side, since on the back of many pregnant women a tone begins, which provokes various pathologies. The specialist covers the test area with gel and begins to drive along it with a sensor.
This study is prescribed for all pregnant women along with the first (18-22 weeks) and second (32-34 weeks) screening. It can be carried out at interim periods if there is evidence.
Causes of blood flow disturbance
To identify a malfunction in the blood circulation system, specialists conduct ultrasound with dopplerometry for women. This allows you to see defects in the vessels, track the amount of oxygen and nutrients entering the fetus.
Very often, expectant mothers wonder why there is a violation of blood flow during pregnancy. The main causes of this condition are:
- Woman's age (too early or, conversely, late).
- A small gap between births.
- Gestosis (late toxicosis during pregnancy).
- Neoplasms in the uterus (for example, myoma), pathology of the myometrium, endometriosis.
- Diabetes.
- Hypertension
- Kidney problems.
- Intrauterine infection due to viral diseases of a woman.
- Multiple pregnancy.
- Numerous abortions or miscarriages.
- Anemia (iron deficiency).
- Placenta previa.
- Rhesus conflict.
- Blood clotting problems leading to blood clots.
Degrees of blood flow disturbance
At the moment, three degrees of pathology are distinguished. The first degree is divided into two subspecies: 1A (violation of the uteroplacental blood flow) and 1B (circulatory problems between the fetus and the placenta). In the second degree, problems arise with both systems (uterus - placenta and placenta - fetus). The third degree is given to those women who have serious complications with blood circulation.
The first stage of the disease can be corrected with drugs, and as a result, a healthy child is born. In other cases, there is a risk of perinatal death.
Types of placental insufficiency
If during the bearing of a baby a blood flow disturbance is detected, then doctors usually diagnose "placental insufficiency". During pregnancy, such a pathology is quite common and can be acute or chronic. The acute form can appear suddenly, at any moment, as a result, the fetus experiences hypoxia and may die. This is possible with premature placental abruption, placental infarction, and blood clots.
The chronic form is much more common acute. Usually it occurs after 13 weeks, and appears in the third trimester. As a result, premature aging of the placenta occurs. Depending on the severity, the disease can be compensated, decompensated, subcompensated, critical.
At the compensated stage, the baby continues to develop normally, since these changes are eliminated by the protective mechanisms of the female body. With decompensated pathology, he ceases to cope with problems, as a result of which the fetus has oxygen starvation, growth retardation and malfunctions of the heart. The subcompensated stage of the disease leads to a delay in the development of the baby, as well as to its possible death. The most complex form is considered critical placental insufficiency. She does not occur very often, but her onset leads to the inevitable death of the child.
The main symptoms of the disease
Depending on the type of blood flow disturbance, various symptoms may appear. Compensated placental insufficiency during pregnancy does not manifest itself in any way, therefore, it is only known about it during an ultrasound scan. With an acute and decompensated form, changes appear in the baby's movements: he moves sometimes too much, then very little. In this case, it is important to monitor this indicator (the fetus should move at least 10 times per day).
As additional signs, there may be slow growth of the abdomen, lack or excess of amniotic fluid. It will not be possible to monitor this independently, so you need to visit a doctor so that he tracks changes in measurements. It happens that a violation of blood flow accompanies gestosis - late toxicosis during pregnancy. To the existing symptoms can be added an increase in pressure, a sharp weight gain, swelling, protein excretion in the urine.
The most dangerous sign of placental insufficiency is the appearance of blood from the birth canal, associated with placental abruption. In this condition, only ambulance specialists will help.
Pathology treatment
If a woman has an increased blood viscosity or a tendency to thrombosis, most often she has a violation of blood flow. During pregnancy, treatment is prescribed only by a doctor, because you have to take serious drugs. Most commonly prescribed drugs are Curantil, Trental and Hofitol. They thin the blood and improve its movement through the arteries.
Most often, pregnant women are prescribed Curantil, which has been used in obstetrics for over 15 years. The drug copes with its tasks perfectly - it normalizes blood circulation due to its dilution, prevents blood clots from forming, helps new vessels to form, increases immunity.
Trental is also in demand, a drug that is similar in action to Curantil. However, it has serious advantages: the medicine does not dilate the blood vessels of the heart and continuously releases the active substance for 12 hours.
It happens that a woman has a mild blood flow disturbance during pregnancy. In this case, treatment is carried out with Hofitol, a drug with mineral and plant components (for example, juice of leaves of field artichoke). It has a mild diuretic effect and does not harm the liver.
Methods of treatment for various degrees of pathology
The first degree of the disease involves the use of drugs that improve blood circulation. Doctors will also conduct dopplerometry and cardiotocography (heartbeat) of the fetus in dynamics. Research should be carried out 1-2 times in 7 days. With positive dynamics, the woman will continue to bear the baby until his birth. If the indicators worsen, it is necessary to conduct daily studies to prevent irreversible changes and timely emergency cesarean section. With normal fetal development, childbirth can occur naturally.
Blood flow disorders of the 2nd degree during pregnancy are also treatable. Usually the same drugs are used as in the first case, but the woman will be offered hospitalization. Doctors will monitor changes in the body and, if necessary, conduct an early delivery.
The third degree is not treated in any way, since irreversible consequences begin to appear. In this case, specialists do not risk the life of the child and prescribe an emergency operation.
Prevention
It is within the power of any woman to make sure that the baby develops and grows without complications. To do this, she will have to monitor her diet: it should have a lot of vitamins, minerals, proteins and other important substances. If the pregnant woman does not suffer from edema, then she is obliged to drink at least 1 liter of liquid daily (preferably water).
It is very important to control your weight - the increase in bearing a baby can be a maximum of 10 kg. Some women need medical prophylaxis that improves blood circulation between the mother and the fetus. It will prevent blood flow disorders during pregnancy. It should be remembered that the correct methodology for managing childbirth and the timely connection of drugs will help to save the baby's life.