Pregnancy is a unique process, carefully planned by nature. Its result is a small copy of mom and dad. The course of pregnancy depends on many factors. Sometimes their negative impact leads to the development of placental insufficiency (FPF). This condition requires medical attention. Otherwise, it can lead to sad consequences.
About the placenta
The placenta is a "temporary" organ. It appears only during pregnancy, but performs a number of important functions:
- Delivers oxygen to the fetus and removes carbon dioxide.
- It transports nutrients necessary for a full life in the womb.
- Carries out the synthesis of hormones to maintain pregnancy (hCG, progesterone, estrogens).
- Protects the child from the effects of harmful substances that enter the body of the mother.
Along with this, the placenta has a unique property to pass nicotine, medications and alcohol.
FPN during pregnancy - what is it?
Both the causes and symptoms of fetoplacental insufficiency should be considered after studying the features of this condition. By pathology, it is customary to understand a whole symptom complex, the appearance of which is associated with morphological and functional changes in the placenta. We are talking about violations in the structure and operation of this "temporary" body.
FPN is a disorder of blood flow in the mother-placenta-fetus system. The progression of the pathology entails a delay in the development of the fetus. The lack of treatment and the complicated course of pregnancy can lead to fetal hypoxia and fetal death.
The main causes and risk factors
FPN during pregnancy is quite common. Doctors explain this trend with a large number of causes of pathology:
- Chronic diseases (diabetes, thyroid disorders, heart defects, hypertension, pathology of the lungs and kidneys).
- Anemia and clotting problems.
- Exacerbation of infectious processes in the body of a woman.
- Pathologies of the reproductive system (menstrual irregularities, uterine fibroids, endometriosis).
- Complicated pregnancy (preeclampsia, placenta previa, Rhesus-conflict pregnancy).
The risk of developing placental insufficiency increases if a woman uses alcohol or drugs, smokes. A large number of abortions in the history can also provoke this violation.
Pathology classification
Fetoplacental insufficiency is usually classified according to several signs.
For example, depending on the moment and mechanism of occurrence, the pathology may be primary or secondary. In the first case, FPI develops until the 16th week of gestation. Violation is the result of an improper implantation process. Secondary pathology occurs when the placenta is already formed under the influence of negative factors from the outside.
Given the clinical course, fetoplacental insufficiency can be acute or chronic. The latter option is divided into compensated, when there are metabolic disorders in the placenta, and decompensated with the progression of the pathological process in the fetal-placenta-mother system.
Clinical picture
Manifestations of fetoplacental insufficiency depend on its form. Compensated FPN during pregnancy is not accompanied by a pronounced clinical picture. The woman feels well. She learns about the diagnosis only after the results of an ultrasound examination.
The decompensated form of acute or chronic FFD is manifested in the form of signs indicating intrauterine hypoxia of the fetus. First, the woman notes the erratic movements of the child, and the doctor notes the increase in his heart rate. In the absence of treatment, the fetal activity decreases, bradycardia joins.
Normally, after the 28th week of pregnancy, the expectant mother should feel at least 10 movements of the baby per day.
Another manifestation of decompensated FSF during pregnancy of a chronic course is a slowdown in the growth of the abdomen of a woman, a delay in the development of the fetus. It is not possible to independently recognize such changes. Only a doctor at the next scheduled examination can detect violations.
The most dangerous sign of FSF is the appearance of spotting from the vagina. In this case, you must immediately call a team of medical workers. Such a symptom indicates premature detachment of the placenta.
Diagnostic Methods
FEP during pregnancy can occur for various reasons. Therefore, the diagnosis of this pathology should be a comprehensive examination.
It begins with a study of the patient's history to identify the main factor contributing to the occurrence of the problem. It is important for the doctor to know about addictions, place of work, the presence of gynecological and other diseases. A woman with FSF may complain of spotting, pain in the lower abdomen, excessive activity of the fetus or its absence.
At the next stage, the doctor examines the gynecological chair. Also, the weight of the pregnant woman and the circumference of her abdomen are taken under control. Thanks to the data obtained already at this stage, we can assume a high risk of renal failure during pregnancy. What kind of pathology is this, what treatment methods are developed for her - the gynecologist must answer these questions during the consultation.
Another informative diagnostic method is ultrasound. With its help, you can evaluate the fetometric readings of the child (the size of the head, trunk and limbs), compare them with standard values. Ultrasound also shows the thickness of the placenta and its degree of maturity.
If there is a suspicion of FPF, cardiotocography and phonocardiography may additionally be required. These studies allow us to evaluate the cardiac activity of the fetus. Bradycardia, arrhythmia or tachycardia - these disorders indicate hypoxia. In addition, pregnant women are prescribed dopplerography. With its help, the doctor evaluates the blood circulation in the vessels of the uterus, the fetal part of the placenta and the umbilical cord.
Therapy Features
There is no universal treatment regimen for FPF during pregnancy. Therapy is selected taking into account the root cause of the violation. Its main goal is to eliminate the etiological factor.
With a compensated form of pathology, treatment is carried out on an outpatient basis. In other cases, a pregnant woman is shown hospitalization with appropriate therapy. It implies the use of the following drugs:
- "Actovegin", "Tocopherol" to normalize blood flow in the placenta-fetus system.
- Antiplatelet agents (Curantil) and anticoagulants (Clexane) to improve blood rheology. These drugs thin the blood and prevent the development of pathological formations in the placenta.
- Calcium channel blockers (Corinfar) to reduce uterine tone.
- Hormonal medicines (Utrozhestan) and vitamin complexes help normalize the metabolism in the placenta. When anemia is detected, iron preparations are prescribed.
Treatment in a hospital continues for at least 4 weeks, followed by outpatient monitoring. The entire course of therapy is about 8 weeks. Its effectiveness is assessed by CTG, ultrasound and dopplerography.
Some women prefer to independently treat FSF during pregnancy, resorting to alternative medicine recipes. However, such an approach is unacceptable. Therapy using prescriptions of folk doctors can harm the fetus, provoking the development of complications. Treatment of fetoplacental insufficiency should be prescribed by a qualified specialist.
Possible consequences
AFN during pregnancy, as a rule, leads to the following complications:
- placental abruption;
- pregnancy overtaking.
In the absence of medical assistance, a child can expect negative consequences. These include developmental delay, respiratory pathologies, and a disorder of neurological status. In the early stages, the risk of fetal death is especially high.
Delivery Methods
A natural variant of delivery is possible only if there is a favorable obstetric picture, a mature cervix and a compensated form of FSF. In this case, the process itself is recommended using epidural anesthesia. In the case of weak labor, stimulation is carried out by prostaglandins. In the second stage, obstetric forceps or fetal vacuum extraction are used.
Early delivery is carried out in the absence of positive dynamics according to the results of ultrasound after 10 days of therapy. If the cervix is immature, the doctor has confirmed fetal retention, there is a burdened obstetric history, a cesarean section is recommended.
Women's reviews
According to reviews, FPI during pregnancy is diagnosed quite often. However, the prognosis for such a diagnosis can be positive if the woman does not ignore the doctor’s prescription. The use of drugs and constant monitoring by the gynecologist allows you to successfully endure a child. Moreover, many women even manage to give birth naturally.
Most often, the pathology is detected in the 2-3rd trimester, when the main systems of the fetal organs are already formed. In the early stages, the main cause of the violation is the use of medicines and alcohol, smoking. Many women are still not aware of their interesting situation, so they prefer to lead a familiar lifestyle. However, the impact of negative factors often ends in failure and leads to fetal death.
At a later date, according to doctors, FPI of the 1st degree during pregnancy is less threatening to the fetus than the third degree of the violation. In the latter case, the level of disorders in the fetal-placental circle reaches critical limits.
Prevention Recommendations
Prevention of FPF during pregnancy comes down to its planning. Even before the onset of conception, a married couple is recommended to undergo the necessary examinations to identify risk factors. If health problems are detected, both parents should undergo treatment, and only after that proceed with planning.
It is necessary to exclude the influence of negative factors: smoking, drinking, taking certain medications. Before pregnancy, it is necessary to cure chronic ailments, and during it to protect yourself from infections. It is important to always observe the regime of work and rest, eat a balanced diet.