What is HFCI during pregnancy? This disease is diagnosed in every third woman expecting a child who is at risk. Under this abbreviation is a medical term that sounds like "chronic fetoplacental insufficiency." Pathology is the result of a complex reaction of the fetus and placenta to various conditions of the mother's body. In this case, violations of the transport, metabolic, trophic and endocrine functions of the placenta are observed, which negatively affects the health of the fetus and newborn.
Risk factors
The diagnosis of CKDF during pregnancy can be due to various factors that gynecologists divide into several groups: social, especially obstetric and gynecological history, features of the course of a particular pregnancy, features of somatic history. The social and domestic causes of placental insufficiency include the age of up to seventeen years or after 35, work in hazardous work, hard physical labor, alcoholism and smoking, psycho-emotional stress.
Often, risk factors for the development of insufficiency are chronic infections, maternal endocrine pathologies, or extragenital diseases (diseases of internal organs that are not directly associated with reproductive disorders). Most often, during pregnancy, heart defects, rheumatism, hypertension and hypotension, varicose veins, anemia, cholecystitis, and diabetes mellitus are exacerbated.
Common causes of CKD include menstrual dysfunction, previous gynecological operations, spontaneous or induced abortions, stillbirths, recurrent gynecological diseases, fibromyoma, endometriosis, birth of small children, infertility. The risk group includes primiparous older than 35 years with uterine myoma. With the same disease, but under the age of 30, the risk of developing CKD is significantly reduced.
Complications of CKDF that are characteristic of a particular pregnancy are gestosis, the threat of interruption, delaying, multiple pregnancy, anemia, exacerbation of chronic diseases. The degree and nature of pathological conditions with such a diagnosis largely depends on the gestational age, the state of the mechanisms in the mother-placenta-fetus system, and also on the duration of exposure to negative factors.
Classification
Pregnancy on the background of HFDP - what is it? The disease is characterized by functional disorders in the placenta, the progression of which can lead to developmental delay, hypoxia, or even intrauterine death of the fetus. Complications are diagnosed in half of pregnant women who are characterized by miscarriage. In a third of cases, CKDF occurs as a complication of gestosis, and after an early infection, it manifests itself in the larger case of observations (about 60%).
Primary and secondary
According to the time of occurrence and the mechanism, primary and secondary insufficiency of the functions of the placenta are distinguished. Primary CKD occurs for up to sixteen weeks. This is due to various violations of implantation and placentation. Secondary failure develops after sixteen weeks under the influence of external factors that negatively affect the fetus or mother with an already formed placenta.
Acute and chronic
According to the clinical course, PSF is distinguished by acute and chronic. Acute more often occurs against the background of placental abruption. Diagnosed mainly in childbirth, but the occurrence of acute placental insufficiency at any time cannot be ruled out. Chronic failure can be diagnosed at any stage of pregnancy. It is divided into compensated, decompensated (degrees are additionally distinguished) and subcompensated.
Compensated form of CKDF during pregnancy - what does it lead to and what does it lead to? This is a pathology in which metabolic processes in the placenta are disturbed, and blood circulation remains normal. At the same time, due to the capabilities of the mother's body, the fetus does not feel discomfort, so the consequences of this form of CKD are minimal. However, observation is necessary, because this form of pathology in the absence of therapy becomes more serious.
A subcompensated form of failure is a condition in which the resources of the mother's body begin to deplete. This happens if you do not eliminate the causes of the compensated form of CKFD. The decompensated form is called the progression of pathology with circulatory disorders in the system "mother - placenta - fetus".
Using dopplerometry, you can determine the degree of decompensated form of placental insufficiency. HFPN 1a during pregnancy is characterized by circulatory disorders only in the uteroplacental blood flow. With form 1b, disorders occur only in the fetal-placental bloodstream. At the second degree, violations are defined at two levels, but are not critical. The third degree of CKDF is a critical level of disruption that puts the life of the fetus at risk.
Symptoms
A serious diagnosis is CKD during pregnancy. What is this pathology and by what symptoms can pathology be suspected? Violations in the mother-placenta-fetus mechanism, which in the most severe case can lead to a delay in the development or intrauterine death of the fetus, can occur due to bacterial or viral infections transferred in the first trimester, endocrine pathologies or genetic disorders. Therefore, the management of patients who are at risk for these factors should be especially careful.
What is it - CFPN with pregnancy compensation? All expectant mothers need to know about this dangerous condition in order to be able to independently identify alarming symptoms and consult a doctor. The disease does not manifest itself in any way. The woman has a satisfactory state of health, and violations can be determined only in the course of additional studies (ultrasound or dopplerometry).
Anxiety symptoms begin to appear only with a decompensated form of placental insufficiency. At first, signs characteristic of various diseases are noted, against the background of which CKD usually develops, namely edema with gestosis or headache with hypertension. In parallel with this, the frequency and intensity of fetal movement decreases.
In case of intrauterine growth retardation, the doctor may note a mismatch in the height of the uterine fundus with the gestation period. This is an indirect symptom, but you should pay attention to it. A dangerous symptom is the appearance of spotting from the vagina at any period of gestation. This indicates premature detachment of the placenta, which can lead to fetal hypoxia. If bleeding occurs, a woman should immediately seek medical help.
Diagnostics
Doctors need to pay more attention to women at risk for developing CKD during pregnancy. What kind of condition is described above. So, at each examination, the gynecologist must pay attention to weight gain, determine the height of the bottom of the uterus and the circumference of the abdomen. A signal for additional studies is a decrease in the number of fetal movements, deafness of the tones of the heartbeat, the inadequacy of the VDM to the pregnancy.
Pathology can be determined using ultrasound, dopplerometry or cardiotocography. Ultrasound diagnosis allows you to assess the condition of the placenta and the fetus, to measure the amount of amniotic fluid. According to the results of dopplerometry, the degree and level of disorders in the system "mother - placenta - fetus" is determined. Also, this diagnostic procedure allows you to choose the optimal therapy. Indirectly judge the condition of the fetus can be on the basis of cardiac activity, which is determined during cardiotocography.
Treatment
CFCI during pregnancy can be treated on an outpatient basis subject to constant monitoring and frequent visits to antenatal clinics, but only if the pathology proceeds in a compensated form. In other cases, observation in a hospital is necessary. All currently existing treatment methods do not fully restore the structure and functions of the placenta, but only contribute to the stabilization of the process and prevent further progression of the pathology.
Preparations
HFPN is treated with drugs that improve blood circulation in the vessels, activating metabolic processes in the fetal tissues. Often, the pathology is accompanied by an increased tone of the uterus, with which "No-shpa", magnesium sulfate, "Ginipral" are prescribed. All therapeutic measures are carried out for at least two weeks. It is possible to monitor the condition of the woman and the fetus using CTG, ultrasound diagnostics or Dopplerometry.
Childbirth at HFPR
If the condition of the fetus is satisfactory, then even with such a diagnosis, a woman can give birth naturally. Otherwise, CKFD is an indication for cesarean section. CS is performed when there is a threat of termination of pregnancy or early detachment of the placenta in the later stages (when the fetus is already viable), with prolonged hypoxia of the fetus recorded during childbirth. Both scheduled and emergency CS can be assigned. It all depends on the specific case.
Risks and consequences
The consequences of CKD during pregnancy for a baby can be very serious, but the risks depend on the type and stage of the pathology. Placental insufficiency can lead to spontaneous interruption, stunted growth and development of the fetus, hypoxia. Also, the risk of fetal death increases. The consequences of CKD during pregnancy are serious, but this diagnosis does not mean that the child will be born with a developmental delay or prematurely. With early detection of pathology and adequate treatment, the prognosis for the mother and fetus is favorable.
Prevention
So, it was determined that this is - CKD during pregnancy. The main preventive measure is to maintain a healthy lifestyle both at the planning stage and during pregnancy, giving up bad habits, good nutrition, and taking vitamins. When planning, it is necessary to undergo an examination by a gynecologist, treat chronic diseases and genital infections. During pregnancy, you should not ignore visits to the antenatal clinic and recommended diagnostic procedures, namely blood and urine tests, ultrasound, and so on.