Fetal hypotrophy during pregnancy - A disease in which the weight and height of the unborn child does not correspond to the full weeks of pregnancy. The wording “intrauterine growth retardation”, abbreviated to VZRP, is more common in the medical literature.
VZRP quite often detected in future mothers with heart disease, excretory, endocrine and reproductive system, as well as women who have bad habits. Children with this pathology are born physically underdeveloped, so after birth they need special care and treatment.
Causes of CDF
Fetal hypotrophy of the fetus can develop due to many factors. The main reasons include:
- age of mother under the age of 17 and over 35,
- smoking, alcoholism, drug addiction, poor living conditions,
- related physical illnesses,
- diseases of the female genital organs,
- multiple pregnancy.
All these factors cause a deterioration of the placental circulation of the fetus, and as a result, its hypoxia.
Symptoms of fetal malnutrition
A preliminary diagnosis of "VZRP" can be made by an obstetrician-gynecologist. Palpation shows a lag in the growth of the bottom of the uterus, or the size of the fetus, so do not neglect the planned visits to the doctor. For further examination, a pregnant woman is sent to an ultrasound scan, where the ratio of all body parts and fetal organs is determined by fetometry. The final diagnosis of "VZRP" is usually made with repeated ultrasound, as it is desirable to conduct monitoring in the dynamics.
An additional method of examination for suspected VZRP is Doppler ultrasound, which assesses the placental blood flow. Fetal hypotrophy during pregnancy at 30 weeks or more can be diagnosed using CTG, which allows you to fix abnormalities in the cardiovascular system of the unborn child.
Treatment of fetal hypotrophy
Nowadays, it is easier to prevent VZRP than to cure it. For this pathology of the fetus mother should abandon bad habits, eat well. Before planning a pregnancy, a woman should be cured or brought to the stage of compensation for diseases of the somatic and genital organs.
Treatment for VZRP is selected individually, is the treatment of the underlying somatic disease. It is necessary to restore the placental blood flow using vasodilators ("Eufillin"). Perhaps the use of tocolytic therapy, which has a relaxing effect on the uterus. This group includes "Ginipral" and "Magne-B6".
With placental circulatory failure, angioprotectors and antiplatelet agents are prescribed to improve the rheological properties of blood. Drugs of choice in this group are “Dipyridamole” and “Pentoxifylline”. VZRP is an indication for therapy with vitamins, especially important vitamin E.
During the treatment of fetal hypotrophy, a woman should carefully monitor her condition, avoid stress, follow all the doctor's recommendations. It is necessary to periodically visit the gynecologist to monitor the effectiveness of treatment. On examination, the doctor will check the condition of the fetus with ultrasound and CTG.
Causes, effects, treatment of fetal hypotrophy
Fetal hypotrophy is a term for lagging in the intrauterine development of a child. Another designation for the same term is intrauterine growth retardation. This diagnosis is very common in the third trimester. It can be delivered by a doctor in the antenatal clinic or a doctor after an ultrasound diagnosis. Why can a baby be delayed in development, on the basis of which this diagnosis is made, is there a treatment, and what are the possible consequences of pathology?
To begin with, we will welcome all expectant mothers - the diagnosis of fetal malnutrition of the 1 st degree usually after delivery is not confirmed. Grade 1 is the easiest when a child lags behind the “norms” by 2 weeks or less. Often this is due to family peculiarities - when all children in a family are born low in weight or if the gestational age is incorrectly set. For reference: the later a pregnant woman first came to the gynecologist for a checkup, the less accurate he would give her a term. In addition, not all women remember exactly the first day of their last menstruation, on which doctors rely when determining the duration of pregnancy. The most accurate diagnosis of the term is possible if a woman knows for sure the day of conception, or if an ultrasound examination was performed in the early stages (2-3 weeks), then the time limit can be set to the exact date.
The doctor develops how the child develops, as far as he can keep up with the “norms”, by measuring the length of the uterus and the volume of the abdomen. They are in the second half of pregnancy very quickly increasing in size. If it happened that the abdomen did not grow in 2-3 weeks, the doctor may recommend inpatient observation and additional ultrasound examination. It is very important in this case, in order to avoid making the wrong diagnoses, that the measurements were carried out each time by the same doctor, guided by all the rules (the woman lies on her back on the couch, with her legs bent at the knees). Sometimes the length of the uterus may suddenly become smaller, but, of course, this does not mean that the child has decreased in size, it is just that he most likely changed his position in the uterus. So, to have a small length of the uterus, but a large volume of the abdomen (measured by the navel) can a woman whose fetus is in a transverse position (lying across the uterus).
In addition, fetal fetometry is performed on each ultrasound scan, starting from the second half of pregnancy, that is, the measurement of individual parts of his body, namely, the measurement of bipartial size, abdominal volume, head circumference, thigh length. Ideally, each parameter received should match the table with the period of pregnancy set by the doctor. However, such an ideal coincidence is rare. Asymmetric hypotrophy of the fetus is detected, that is, when the size of the head, for example, is 33 weeks, the abdominal circumference and the length of the thigh are 32. Often this does not mean any pathology, but only an error in measurement. There are three degrees of fetal malnutrition:
- 1 - delay up to 2 weeks,
- 2 - delay to 4 weeks,
- 3 - backlog of more than 4 weeks.
What are the causes of pathology? No, no, it's not about bad nutrition, although this can also be the cause of the delayed development of the fetus. Much more often, the child develops slowly because of the ingestion of toxic substances in the maternal organism - tar, nicotine, alcohol, etc. Another very common cause of the pathology is infections. Cytomegalovirus, toxoplasmosis, latent sexually transmitted infections - all this must be tested and, if necessary, treated before pregnancy.
In addition, fetal hypotrophy is often observed with late toxicosis of pregnant women (preeclampsia), hypertension (high blood pressure), taking certain medications, cardiovascular diseases, pathologies of the placenta (premature maturation). And also with multiple pregnancies, diabetes and chromosomal abnormalities. Sometimes the cause may be tight entanglement of the umbilical cord.
What to do if the child develops slowly? Eating right and not starving is by itself. And the doctor should closely monitor the condition of the patient and her child. Dopplerography and cardiotocography are required, which allow us to say for sure whether the blood flow in the vessels of the placenta and umbilical cord is disturbed and whether the fetal heart rate is changed. Fetal hypotrophy treatment can be cardinal only in the form of a cesarean section, which is performed if the child is very weak for independent birth. Drug support during pregnancy is also being carried out, but it cannot be called very effective. Drug administration contributes to a slight improvement in the delivery of oxygen and nutrients to the baby. But if the reason for the delay in the development of a child is not in the pathology of the placenta, but, say, in an infection, then the problem is much more serious and thus cannot be solved.
Fetal hypotrophy, fortunately, does not always have consequences. As we wrote above, it all depends on the degree. The first degree usually does not bear any harm to the child, and the second and third can seriously affect his physical and mental development.
What is fetal hypotrophy?
The term "fetal hypotrophy" is used when talking about intrauterine growth retardation of the child. As already noted, this diagnosis is most often placed in the third trimester.
The degree of development of the baby is determined by the doctor, comparing the data obtained by him during the examination, measuring the length of the uterus and the volume of the abdomen. Starting from the second half of pregnancy, the belly rather quickly grows in size. If at the next appointment the doctor notices that the stomach has not grown in the last two or three weeks, he will ask the woman to undergo an additional ultrasound examination. During an ultrasound examination, a specialist takes measurements of individual parts of the child’s body (fetal photometry). During this study, he will definitely pay attention to the size and circumference of the head, abdomen, and length of the thigh.
To avoid an error in the diagnosis, it is better to go to the same doctor, since different specialists may interpret the same indicators in different ways. There are three degrees of fetal malnutrition.
Fetal hypotrophy of the first degree - the easiest. She is exposed if the child’s development lags behind the established norms by less than 2 weeks. As a rule, this diagnosis after birth is not confirmed. The smallness of the fetus in these cases is often associated with family characteristics (if all children in the genus are born small), or if an error is made when setting the period of pregnancy. The second degree of malnutrition implies a delay of up to 4 weeks, and the third - more than 4 weeks. If the first degree, as a rule, does not harm the child, then the second and third may very seriously affect both the physical and mental development of the child.
There are two forms of malnutrition - symmetrical and asymmetrical. Speaking about the symmetric form of fetal malnutrition, imply that absolutely all organs are reduced in size and do not correspond to the duration of pregnancy. When asymmetric hypotrophy is observed uneven development of various organs. For example, a child may have a brain or skeleton within the normal range, but it may be lagging behind in the development of the kidney, liver, etc. As a rule, the asymmetric form of malnutrition develops after 28 weeks of pregnancy.
What is dangerous fetal hypotrophy syndrome?
Fetal hypotrophy 1 degree is not dangerous. A woman only needs to get rid of the factors causing the disease. Enhanced and proper nutrition, the use of vitamins, minerals, vegetables and fruits, meat, fish and other healthy foods contribute to the fruit of all the necessary nutrients.
The remaining degrees are harmful to the child and can affect future psychological and physical development.
Hypotrophy can weaken the fetus so that it does not go through the birth canal on its own. In such cases, women are prescribed a caesarean section. After birth, a child may be lagging behind his peers in terms of weight and development, but with timely treatment and follow-up of a doctor’s recommendations, all indicators return to normal in a few years. By physical parameters, the baby will not differ from the same age children.
Consequences of hypotrophy
The consequences of hypotrophy for a child depend on the cause that caused it. For example, if alcohol or drugs affected a fetus during pregnancy, the probability of having a baby with acquired dementia increases.
In such children, immunity has been lowered since birth, their bodies will be poorly resistant to infectious diseases. In childhood, any cold should be given special attention. The weakness of the child and the weight mismatch are corrected by proper nutrition and special exercise. With good feeding, weight returns to normal.
Diagnosis of fetal hypotrophy
The disease cannot be detected without modern medical devices. By the size of the abdomen of a pregnant woman, only a predisposition to malnutrition can be determined. But sometimes this indicator is wrong. Women with a small belly can give birth to absolutely healthy children, and with a big one - on the contrary. Due to the increased amount of amniotic fluid, the doctor may not see the disease.
The following methods are used to diagnose hypotrophy:
- Ultrasound. Gives you the opportunity to get fetometric indicators, to assess the condition of the placenta.
- Doppler. Allows you to analyze the blood flow in the uterine vessels, to evaluate the umbilical cord, cerebral arteries.
- Ultrasound cardiotocography. It is applied after 30 weeks of pregnancy. The method allows to assess the work of the cardiovascular system of the fetus.
Prevention of fetal hypotrophy
The best way to prevent a disease is to plan a pregnancy. For at least 3 months, a woman is recommended to give up all bad habits. Alcohol, smoking, use of narcotic substances will negatively affect the child’s development. Also, future parents should be examined for genital infections that may affect the course of pregnancy.
If there are chronic infections in the body, then it is necessary to carry out prophylaxis so that the disease does not worsen during the period of carrying the child.
At the first sign of pregnancy, you need to contact a gynecologist and register with the antenatal clinic.
Also recommended for prevention:
- limit the impact of stress factors
- reduce the amount of physical work and be more fresh outdoors
- choose a safe place to stay during pregnancy (lack of radiation, clean ecology).
Fetal hypotrophy during pregnancy is a serious diagnosis. Only the initial stage of the disease does not pose a threat. 2 and 3 degrees of malnutrition are dangerous for the further physical and mental development of the child.
In order for the baby to be born completely healthy, you need to follow the recommendations of the doctor and eat fully. Bad habits never adorned a woman. And during pregnancy, the future mother, who uses alcohol or nicotine, puts the child at risk of developing malnutrition, which is extremely dangerous.
Author: Khatuna Gabelia, doctor,
specifically for Mama66.ru
Fetal hypertrophy during pregnancy: causes and effects
Hypotrophy during pregnancy is a delay in physical intrauterine development, in which height and weight are far behind the norm. The main pathological factors are toxic substances that enter the mother's body (alcohol, nicotine).
Other causes affecting physical performance of the infant:
- infectious diseases - cytomegalovirus, toxoplasmosis, STDs,
- toxicosis in the last trimester,
- diabetes, hypertension and renal failure,
- heart diseases,
- conception that came before 18 or after 35,
- dystrophy of the maternal organism.
Types of fetal hypertrophy
The syndrome of insufficient size of the child, in medical practice, is divided into two types:
- Symmetric hypertrophy characterized by formation in the early stages. All organs and body parameters are uniformly reduced relative to each other. The main factor in the emergence of doctors called infection, genetic predisposition or poor nutrition of the mother.
- Asymmetrical - occurs in the third trimester, after 28 weeks. This form of the syndrome is caused by the uneven size of individual organs. When external parameters meet the standards, and internal organs are formed with a delay.
Fetal hypotrophy 1 degree during pregnancy
A lag in development for a period not exceeding two weeks indicates the formation of malnutrition of severity 1. Such a diagnosis is quite common and does not pose a threat to the life of the child.
Doctors in diagnosing, above all, pay attention to the constitution of the body of the expectant mother. If the woman is thin, then this feature was transmitted to the infant, i.e. heredity plays an important role.
To ensure no complications, experts prescribe additional studies of the functioning of the placenta and blood flow. To understand how well the child eats, whether there is a lack of oxygen intake.
Consequences of delayed development
The main factor influencing the fetus hypertrophy is the inability to independently pass through the birth canal. Вторая стадия тяжести нарушает нервную систему в период вынашивания, такие дети тяжело набирают массу тела, возможны тяжелые последствия в будущем.
При легкой форме гипертрофии, малышу придется добирать массу в первый год жизни вне утробы. In children with this syndrome, immunity is often reduced, so catarrhal diseases become frequent. But in the presence of breastfeeding and with proper care, such children, already outside the womb, collect weight, and develop on a par with other children.
Fetal malnutrition forms
There are two forms of this syndrome.
1) Symmetric form of fetal malnutrition.
May appear in early pregnancy. With her limbs, organs of the fetus are evenly reduced. That is, the child is smaller than the size that should be at this time.
- chromosomal pathology,
- mother smoking
- insufficient nutrition of a pregnant woman,
- intrauterine infection,
- fetal malformations.
2) Asymmetric form of fetal malnutrition.
Formed after the twenty-eighth week of pregnancy. When it slowed down the development of only certain organs. The size of the skeleton, brain and limbs correspond to a specific period of pregnancy. A development of the kidneys, the liver is lagging behind. On ultrasound, an asymmetric form is diagnosed on a small (less than normal) abdominal circumference.
The severity of fetal malnutrition, depending on the severity of developmental delay:
1) Fetal hypotrophy of 1 degree (the lag in size varies within two weeks).
This diagnosis is made, but most often they are not taken seriously. Development lag can only be visible. The mismatch of the size of the fetus - this is a feature of the child, confusion in the timing. Finding out the pathological or normal this discrepancy helps study the placenta, the state of blood flow in it, CT scan after 32 weeks of pregnancy.
2) Hypotrophy 2 degrees (developmental delay by two to four weeks).
This lag is not considered normal. Since it is possible only in violation of the functions of the placenta. In case of fetus hypotrophy 2 degrees, inpatient treatment is indicated.
3) Fetal hypotrophy 3 degrees (developmental delay of more than four weeks).
The state of complete exhaustion of the child in the womb. It is classified as a "neglected case" and indicates a serious distress.
Causes of asymmetric fetal malnutrition
The following groups of causes can lead to impaired uteroplacental blood flow and poor nutrition of the fetus:
1) Social and domestic. it
- age of the woman (less than seventeen and more than thirty years),
- bad habits (alcohol use, smoking),
- hard physical work, work with toxic chemicals,
- emotional overstrain.
2) Mother's state of health. it
- chronic infections (tonsillitis, trachobronchitis and others),
- pathologies of various organs (diseases of the heart, blood vessels, kidneys, endocrine system).
3) Gynecological diseases, the course of previous pregnancies. it
- irregular menstrual cycle or previous infertility due to hormonal disorders,
- history of miscarriages
- pathology of the uterus (endometriosis, myoma, scar after surgery).
4) Difficult course of the existing pregnancy. it
- risk of miscarriage,
- low blood pressure
- multiple pregnancy,
- exacerbations of chronic infections.
All these causes can disrupt the blood supply to the uterus and fetus. As a result, the child receives insufficient oxygen and nutrients. Oxygen starvation develops, growth rates slow down.
Newborns hypotrophy: causes and symptoms
Newborn babies may develop hypotrophy under the influence of the following factors:
- congenital abnormalities of the digestive tract,
- lack of breast milk from the mother,
- improper feeding pattern,
- lactose intolerance,
- frequent infectious and catarrhal diseases.
Diagnostic indicator - insufficient weight gain.
Clinical signs of malnutrition in newborns:
- little weight,
- lack of physical and mental activity,
- reduced skin turgor
- dry skin and mucous membranes,
- the minimum amount of subcutaneous fat.
Treatment of malnutrition neonatal
The first stage is the diagnosis and elimination of causes.
Next you need to adjust the diet and calorie intake. If the baby is breastfed, then all attention is paid to the mother's diet. She needs to consume more protein products, introduce mineral and vitamin complexes.
In the absence of results within two weeks, the child is transferred to a mixed type of feeding. With lactose, breast milk is completely replaced by mixtures.
Share this article with friends:
Forms and degrees of fetal malnutrition
Depending on the period of development, VZRP emit:
- Symmetric fetal hypotrophy. This type of pathology appears in 1-2 trimester, while the future child has evenly reduced parts of the body.
- Asymmetric fetal hypotrophy. Usually, this form of VZRP appears after 2 trimesters. This species is characterized by varying degrees of maturity of the organs.
Fetal hypotrophy during pregnancy is also classified according to the degree of developmental delay:
- Fetal hypotrophy 1 degree. It is characterized by a developmental delay of less than 14 days of gestational age. This diagnosis is sometimes made by mistake due to measurement errors.
- Fetal hypotrophy 2 degrees. There is a slowdown in the development of 14-28 days gestational period. More serious pathology, requires emergency treatment.
- Fetal hypertrophy 3 degrees. The future child lags behind in his physical development at 28 days of pregnancy and more, is rare.
Why does fetal hypotrophy develop?
As a rule, the cause of malnutrition of the fetus is not a bad diet, although sometimes this factor stimulates the development of such a condition. The most common cause of delayed fetal development is smoking and drinking alcohol. Tar, nicotine, alcohol - these and other toxic substances act on the fetus extremely negatively.
Another fairly common cause of fetal malnutrition is sexually transmitted infections. These include toxoplasmosis, cytomegalovirus. as well as hidden infections. Therefore, it is important to determine their presence or absence even before the onset of pregnancy and, in the case of a positive response, to recover.
Gestosis (late toxicosis of pregnancy) - can also cause the development of hypotrophy. At risk groups include pregnant women with hypertension, cardiovascular diseases, diabetes. Hypotrophy may also develop as a result of taking certain medications, premature maturation of the placenta, multiple pregnancies, or chromosomal abnormalities.
If a woman is less than 17 years old or more than 35 years old, or if she works at an enterprise that requires hard physical labor, emotional overstrain, work with toxic chemicals, then in case of pregnancy, there is a high risk of slowing physical growth of the fetus.
General characteristics of the disease
Hypotrophy is a phenomenon in which its fetometric indices (weight, height, length of extremities) do not meet the standards that should be observed at a certain period of pregnancy.
The occurrence of this pathology can cause certain reasons, which should include:
- bad habits of a pregnant woman (alcohol and drugs, smoking),
- preeclampsia (characterized by increased pressure + protein in the urine, and often edema),
- the presence of a chromosomal abnormality in the fetus (then in the second / third planned ultrasound, any pathology in the development of internal organs is detected, a very short nasal bone or its absence),
- uncontrolled diabetes in pregnant women,
- too young woman in labor (less than 17 years old) or about 40 years old,
- work that involves contact with chemicals
- tight fetal umbilical cord fetus or other violation of the blood flow in the umbilical cord (when the baby does not receive the right amount of nutrients and oxygen),
- premature aging, detachment or inflammation of the placenta,
In addition to the above reasons, there are many other factors that can cause fetal hypotrophy.
Forms and stages
The intrauterine growth retardation of the fetus is divided into 2 forms:
- Symmetric hypotrophy. The deviation is determined if all parts of the body are evenly reduced in the fetus, i.e. All the main fetometric indicators are significantly lower than the normal indicators that must be present at a specific gestational age.
- Asymmetric hypotrophy. It is diagnosed if the individual parts of the body of the fetus correspond to normal sizes for a certain period, and some of them do not. Asymmetric malnutrition occurs most often after 28 weeks of gestation.
There is also a classification of hypotrophy, depending on how many weeks the fetus is lagging behind in development:
- First degree It is characterized by a delay in development for a period of not more than 2 weeks. Such a diagnosis is not uncommon. It is not life threatening to the fetus.
- Second degree The developmental delay in this case exceeds 2 weeks, but is less than 4 weeks. Such a diagnosis is more dangerous than the first, so in this case, treatment is required.
- Third degree Growth delay is more than 4 weeks. In such situations, they often resort to premature delivery.
Often in women with irregular or long menstrual cycles, the term gynecologist establishes the duration of pregnancy is not true and then the diagnosis of intrauterine growth retardation (SISD) is erroneous. Therefore, it is important to register in the LCD before the onset of 12 weeks and conduct the first planned ultrasound on time. Only by the results of the first planned ultrasound can one judge a real gestational age. But if a woman registers later, then there is a confusion with the terms, and then unnecessary treatment will be prescribed, and the pregnant woman herself will experience great stress and anxiety about the state of health of the child.
Danger and consequences of deviation
First-degree hypotrophy poses no threat to the life and health of the unborn child. If the deviation is more serious, then it carries a certain threat, because the internal organs often with hypotrophy of the 2nd and 3rd stages are underdeveloped and cannot fully perform their function.
A newborn with a grade 2 sputum may be delayed and underweight. However, in uncomplicated cases, with proper and timely treatment, the infant will catch up with its peers for several years and will not be different from healthy children.
With a third degree of fetal developmental delay, the baby may not even survive. Therefore, if fetal hypotrophy is detected after 24 weeks, then emergency measures are often resorted to. First, the pregnant woman is placed in the hospital under the careful supervision of physicians. Doctors can introduce pregnant betamethasone or dexamethasone for the early maturation of the fetal lungs, so that when the health of the baby deteriorates, a cesarean section can be performed. Further, the newborn will be nursed in a young woman.
The most serious complication of fetal hypotrophy is the underdevelopment of the nervous system, as a result of which the child may experience mental retardation.
To reduce the risk of malnutrition in the fetus should be carefully prepared for carrying a child in the planning period of pregnancy. At least three months before conception, you must seriously take care of your own health. It is necessary to give up bad habits (smoking, alcohol, taking drugs), both partners need to undergo a full examination for the detection of genital and chronic infections and (if they are found) to take up treatment.
Before the onset of 12 weeks of pregnancy, you should definitely visit a gynecologist and register with the LCD.
It is also necessary to adhere to such prophylactic measures:
- try to be less nervous
- make daily walks in the fresh air,
- do not overload the body with physical exertion,
- follow the nutrition, which should be balanced and rich in seasonal vegetables and fruits, meat, cereals and jelly,
- sleep at least 8 hours a day.
The above measures will help prevent the development of the disease and maintain the health of the mother and child.
Any disease is better to prevent. Fetal delays in fetal development is no exception. In order for the fetus to develop fully and correctly, the expectant mother needs to protect herself from nervous shocks, various diseases, and physical exertion.