FPN during pregnancy: causes, diagnosis, treatment methods, reviews

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

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 fetoplacental insufficiency (FPI). 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:

1. Brings oxygen to the fetus and removes carbon dioxide.
2. Transports the nutrients necessary for a full life in the womb.
3. Synthesizes hormones to maintain pregnancy (hCG, progesterone, estrogens).
4. Protects the baby from harmful substances ingested by the mother.

At the same time, the placenta has a unique property to pass nicotine,drugs and alcohol.

FPN during pregnancy - what is it?

Both the causes and symptoms of placental insufficiency should be considered after studying the characteristics of this condition. Under 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 work of this "temporary" body.

FPN is a blood flow disorder in the mother-placenta-fetus system. The progression of the pathology entails a delay in the development of the fetus. Lack of treatment and complicated pregnancy can lead to intrauterine hypoxia and fetal death.

Main causes and risk factors

FPN during pregnancy is quite common. Doctors explain this trend with a large number of causes of pathology:

1. Chronic diseases (diabetes, thyroid disorders, heart defects, hypertension, lung and kidney pathologies).
2. Anemia and bleeding problems.
3. Exacerbation of infectious processes in a woman's body.
4. Pathologies of the reproductive system (menstrual irregularities, uterine fibroids, endometriosis).
5. Complicated pregnancy (preeclampsia, placenta previa, Rh-conflict pregnancy).

The risk of developing placental insufficiency increases if a woman drinks alcohol or drugs, smokes. A high number of abortions in history can also provoke this disorder.

Classification of pathology

Fetoplacental insufficiency is usually classified according to several criteria.

For example, depending on the moment and mechanism of occurrence, pathology can be primary or secondary. In the first case, FPI develops before the 16th week of gestation. Violation is a consequence of an incorrect implantation process. Secondary pathology occurs when the placenta is already formed under the influence of negative external factors.

Depending on 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 fetus-placenta-mother system.

Clinical picture

Manifestations of placental insufficiency depend on its form. Compensated hr. FPI during pregnancy is not accompanied by a pronounced clinical picture. The woman feels good. She will only find out about the diagnosis after the results of the ultrasound examination.

Decompensated form of FPI of acute or chronic course manifests itself in the form of signs indicating intrauterine fetal hypoxia. First, the woman notes the erratic movements of the child, and the doctor notes the increase in his heartbeat. If left untreated, fetal activity drops, 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 FPI during chronic pregnancy is a slowdown in the growth of the woman's abdomen, 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 identify violations.

The most dangerous sign of FPI is the appearance of bloody discharge from the vagina. In this case, you need to immediately call a team of medical workers. Such a symptom indicates premature detachment of the placenta.

Diagnostic Methods

FPN during pregnancy can occur for various reasons. Therefore, the diagnosis of this pathology should be a comprehensive examination.

It begins with a review of the patient's history to identify the underlying factor that contributed to the problem. It is important for a doctor to know about addictions, place of work, the presence of gynecological and other diseases. A woman with FPI may complain of spotting, pain in the lower abdomen, excessive or no fetal activity.

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. Based on the data obtained, a high risk of FPI during pregnancy can already be assumed at this stage. What kind of pathology is this, what methods of treatment have been developed for it - the gynecologist should answer these questions during the consultation.

Another informative diagnostic method is ultrasound. It can be used to evaluate fetometric readingschild (size of the head, torso and limbs), compare them with the normative values. Ultrasound also shows the thickness of the placenta and the degree of its maturity.

If FPI is suspected, cardiotocography and phonocardiography may be additionally required. These studies allow you to evaluate the cardiac activity of the fetus. Bradycardia, arrhythmia or tachycardia - these violations indicate hypoxia. In addition, dopplerography is prescribed for pregnant women. 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.

Features of therapy

There is no one-size-fits-all treatment for FPI 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, the pregnant woman is shown hospitalization with appropriate therapy. It implies the use of the following drugs:

1. "Actovegin", "Tocopherol" to normalize blood flow in the placenta-fetus system.
2. Antiaggregants ("Kurantil") and anticoagulants ("Clexane") to improve the rheological characteristics of blood. These drugs thin the blood and prevent the development of pathological formations in the placenta.
3. Calcium channel blockers ("Corinfar") to reduce the tone of the uterus.
4. Hormonal drugs ("Utrozhestan") and vitamin complexes help to normalize the metabolism in the placenta. If anemia is detected, drugs are prescribediron.

Inpatient treatment lasts at least 4 weeks, followed by outpatient follow-up. The entire course of therapy is about 8 weeks. Its effectiveness is evaluated by CTG, ultrasound and Doppler sonography.

Some women choose to self-treat FPI during pregnancy using alternative medicine prescriptions. However, such an approach is unacceptable. Therapy using recipes of folk healers can harm the fetus, provoking the development of complications. Treatment of placental insufficiency should be prescribed by a qualified specialist.

Possible consequences

FPI during pregnancy typically results in the following complications:

• placental abruption;
• pregnancy prolongation.

In the absence of medical assistance, negative consequences may also await the child. These include developmental delay, respiratory pathologies, neurological status disorder. In the early stages, the risk of intrauterine fetal death is especially high.

Methods of delivery

A natural delivery option is possible only if there is a favorable obstetric picture, a mature cervix and a compensated form of FPI. In this case, the process itself is recommended to be carried out using epidural anesthesia. In the case of weak labor activity, stimulation is carried out with prostaglandins. At the second stage, obstetric forceps or vacuum extraction of the fetus are used.

Early delivery is performed whenthe 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 caesarean section is recommended.

Reviews from women

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 instructions. The use of medications and constant monitoring by a gynecologist allows you to successfully bear a child. Moreover, many women even manage to give birth naturally.

Most often, pathology is detected in the 2nd-3rd trimester, when the main organ systems of the fetus are already formed. In the early stages, the main cause of the violation is the use of medicines and alcohol, smoking. Many women are not yet aware of their interesting position, so they prefer to lead a familiar lifestyle. However, the impact of negative factors often ends in failure and leads to intrauterine death of the fetus.

At a later date, according to doctors, FPI of the 1st degree during pregnancy threatens the fetus less than the third degree of violation. In the latter case, the level of disorders in the fetal-placental cycle reaches critical limits.

Recommendations for prevention

Prevention of FPI during pregnancy comes down to planning. Even before the onset of conception, a married couple is recommended to undergo the necessary examinations to identify risk factors. When problems are found withhe alth, both parents should undergo treatment, and only then begin planning.

It is imperative to exclude the influence of negative factors: smoking, drinking alcohol, taking certain medications. Before pregnancy, it is necessary to cure chronic ailments, and during it, protect yourself from infections. It is important to always observe the regime of work and rest, eat a balanced diet.