HFPN during pregnancy: what is it?

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

What is HFPN during pregnancy? This disease is diagnosed in every third woman who is expecting a child, who is at risk. This abbreviation hides 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 maternal organism. At the same time, violations of the transport, metabolic, trophic and endocrine functions of the placenta are observed, which negatively affects the he alth of the fetus and newborn.

Risk factors

The diagnosis of HFPN during pregnancy can be due to various factors that gynecologists divide into several groups: social and household, features of obstetric and gynecological history, features of the course of a particular pregnancy, features of somatic history. The social causes of placental insufficiency include the age of up to seventeen years or after 35, work in hazardous production, severe physicalwork, alcoholism and smoking, psycho-emotional stress.

Often, risk factors for the development of insufficiency are chronic infections, endocrine pathologies of the mother or extragenital diseases (diseases of internal organs that are not directly related to reproductive dysfunction). Most often, during pregnancy, heart defects, rheumatism, hypertension and hypotension, varicose veins, anemia, cholecystitis, diabetes mellitus are exacerbated.

Common causes of HFPN include menstrual dysfunction, previous gynecological surgery, spontaneous or induced abortion, stillbirth, recurrent gynecological disease, fibroids, endometriosis, low birth weight, infertility. The risk group includes nulliparous older than 35 years with uterine myoma. With the same disease, but before the age of 30 years, the risk of developing HFPN is significantly reduced.

Complications of HFPN, which are typical for a particular pregnancy, are gestosis, the threat of miscarriage, overmaturity, multiple pregnancy, anemia, exacerbation of chronic diseases. The degree and nature of pathological conditions with such a diagnosis largely depends on the duration of pregnancy, the state of the mechanisms in the system "mother - placenta - fetus", as well as on the duration of exposure to negative factors.

Classification

Pregnancy against the background of HFPN - 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. A complication is diagnosed in half of pregnant women who are characterized by miscarriage. In a third of cases, HFPI occurs as a complication of preeclampsia, and after an early infection, it manifests itself in a larger case of observations (about 60%).

Primary and secondary

According to the time of occurrence and mechanism, primary and secondary placental insufficiency is distinguished. Primary HFPN occurs up to sixteen weeks. This is due to various kinds of violations of implantation and placentation. Secondary insufficiency develops after sixteen weeks under the influence of external factors that adversely affect the fetus or mother with an already formed placenta.

Acute and chronic

According to the clinical course, FPI is divided into acute and chronic. Acute often occurs against the background of placental abruption. It is diagnosed mainly in childbirth, but the occurrence of acute placental insufficiency at any time cannot be ruled out. Chronic insufficiency can be diagnosed at any stage of pregnancy. It is divided into compensated, decompensated (degrees are additionally distinguished) and subcompensated.

Compensated form of HFPN during pregnancy - what is it 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 maternal organism, the fetus does notexperiencing discomfort, so that the consequences of this form of HFPN are minimal. However, observation is necessary, because this form of pathology, in the absence of therapy, becomes more serious.

Subcompensated form of insufficiency is a condition in which the resources of the mother's body begin to deplete. This happens if the causes of the compensated form of HFPN are not eliminated. The decompensated form is the progression of pathology with circulatory disorders in the "mother - placenta - fetus" system.

With the help of 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. In form 1b, disturbances occur only in the fetal-placental blood flow. At the second degree, violations are determined at two levels, but are not critical. The third degree of HFPN is a critical level of impairment that puts the life of the fetus at risk.

Symptoms

Serious diagnosis - HFPN during pregnancy. What is this pathology and what symptoms can be suspected of pathology? Violations in the mechanism "mother - placenta - fetus", which in the most severe case can lead to developmental delay or intrauterine death of the fetus, may occur due to bacterial or viral infections suffered in the first trimester, endocrine pathologies or genetic disorders. Therefore, special attention should be paid to the management of patients who are at risk for thesefactors.

What is it - HFPN with compensation during pregnancy? All expectant mothers need to know about this dangerous condition in order to independently be able to identify alarming symptoms and consult a doctor. The disease practically does not manifest itself. The woman feels satisfactory, and violations can only be determined during additional studies (ultrasound or dopplerometry).

Alarming symptoms begin to appear only with decompensated form of placental insufficiency. First, there are signs characteristic of various diseases, against which HFPN usually develops, namely edema with preeclampsia or headache with hypertension. In parallel with this, the frequency and intensity of fetal movement decreases.

In the case of intrauterine growth retardation, the doctor may note a discrepancy between the height of the uterine fundus and the gestational age. This is an indirect sign, but you should pay attention to it. A dangerous symptom is the appearance of bloody discharge from the vagina at any gestation period. This indicates premature detachment of the placenta, which can lead to fetal hypoxia. If bleeding occurs, a woman should seek immediate medical attention.

Diagnosis

Physicians need to pay more attention to women at risk for developing HFPN during pregnancy. What is this state, it was described above. So, at each examination, the gynecologist should pay attention to weight gain, determine the height of the fundus of the uterus and the circumference of the abdomen. Signal foradditional studies are a decrease in the number of fetal movements, the deafness of the heartbeat tones, the discrepancy between the VDM and the gestational age.

You can determine the pathology using ultrasound, dopplerometry or cardiotocography. Ultrasound diagnostics allows you to assess the condition of the placenta and fetus, measure the amount of amniotic fluid. According to the results of dopplerometry, the degree and level of violations in the "mother - placenta - fetus" system are determined. Also, this diagnostic procedure allows you to choose the optimal therapy. Indirectly, the state of the fetus can be judged by cardiac activity, which is determined during cardiotocography.

Treatment

HFPN during pregnancy can be treated on an outpatient basis, subject to constant monitoring and frequent visits to the antenatal clinic, but only if the pathology occurs in a compensated form. In other cases, observation in the hospital is necessary. All currently existing methods of treatment do not allow to 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.

Drugs

HFPN is treated with drugs that improve blood circulation in the vessels, activating metabolic processes in the tissues of the fetus. Often, the pathology is accompanied by an increased tone of the uterus, and No-shpa, magnesium sulfate, Ginipral are prescribed. All therapeutic measures are carried out for at least two weeks. Monitor statewomen and the fetus can be using CTG, ultrasound diagnostics or dopplerometry.

Childbirth with HFPN

If the condition of the fetus is satisfactory, then even with such a diagnosis, a woman can give birth naturally. Otherwise, HFPN is an indication for caesarean section. CS is performed with the threat of abortion or early placental abruption in the later stages (when the fetus is already viable), with prolonged fetal hypoxia recorded during childbirth. Both planned and emergency CS can be prescribed. It all depends on the specific case.

Risks and Consequences

The consequences of HFPN during pregnancy for a child can be very serious, but the risks depend on the type and stage of the pathology. Placental insufficiency can lead to spontaneous abortion, growth retardation and fetal development, hypoxia. It also increases the risk of intrauterine fetal death. The consequences of HFPN 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 HFPN during pregnancy. The main preventive measure is maintaining a he althy lifestyle both at the planning stage and during pregnancy, giving up bad habits, good nutrition, taking vitamins. When planning, it is necessary to undergo an examination by a gynecologist, treat chronic diseases and sexual infections. Duringpregnancy should not ignore visits to the antenatal clinic and recommended diagnostic procedures, namely blood and urine tests, ultrasound, and so on.