Problems with communication. Fetoplatsentarny insufficiency of
Unfortunately, not always pregnancy proceeds without complications. In certain cases for safety of mother and the kid offer the woman hospitalization in maternity hospital, in office of pathology. What can become a reason for treatment in a hospital?
Sometimes to future mothers should hear from the doctor the diagnosis “fetoplatsentarny insufficiency“. What this complication of pregnancy and as far as it is dangerous consists in?to
As arranged a placenta?
the Placenta is not incidentally called “body of pregnancy“ - it cannot be carried neither to bodies of the woman, nor to bodies of the kid. The placenta from a horion - a fleecy cover of a fruit develops. Formation of a placenta completely comes to an end to 16 - 18 - y to week. The placenta resembles flat cake about 3 cm thick, with a diameter of 18 cm and weighing from 500 to 800 g superficially. The mature placenta consists of 15 - 20 segments divided by partitions from connecting fabric. The placenta is attached by one party to an internal wall of a uterus; this surface of a placenta is called maternal. Other surface of a placenta - fruit - is turned into a uterus cavity, to the kid. The fruit surface of a placenta is covered amniony - a fetal cover (a wall of a fetal bubble).by
during pregnancy in an organism of future mother forms an additional, third circle of blood circulation - between mother and a fruit. The most important component of this blood circle is the placenta, in it vessels of mother and kid meet. The new blood system and is called - system mother - a placenta - a fruit.
the Placenta for 80% consists of blood vessels. Generally it is small vessels. The vascular network of a placenta consists of two systems: matochno - placentary and fruit. Matochno - placentary vessels bring blood from uterus vessels, that is from a maternal organism, in interfleecy space from where blood flows back to a uterus on veins. At the same time blood current on matochno - a placentary network quite slow: sosudik are small, and the interfleecy space of a placenta is extensive. Fruit vessels consist of branchings of two funic arteries. One large branch of an artery approaches each segment of a placenta. In a segment the vessel branches so that it was the share of each fiber of a placenta on a sosudika. These vessels of fibers break up on absolutely small - capillaries. The ends of arterial capillaries pass into venous capillaries, and those merge in more and more large vessels forming as a result a funic vein.
Thus, each segment of a placenta consists of a rich vascular network. And blood systems of mother and a fruit remain absolutely isolated. But, in spite of the fact that blood of mother and a fruit does not mix up anywhere, between a maternal organism and the kid there is rather intensive metabolism - through the thinnest membrane of walls of capillaries.
during pre-natal development of a fruit the placenta carries out extremely important mission - functional life support of the kid. Actually the placenta is the peculiar portable power supply unit which is carrying out communication between a maternal organism and a fruit. Value of this communication is huge: till the birth the kid is not capable to independent existence. Both oxygen, and nutrients, so necessary for the normal growth and development of a children`s organism, get to a fruit from mother`s organism through a placentary blood-groove. Needless to say that the substances fulfilled and already unnecessary a fruit, products of an exchange come through a placenta back to a maternal organism for removal through kidneys of future mother.
Here main functions of a placenta:
- gas exchange: from maternal vessels the oxygen necessary for breath of a fruit comes to fruit and carbon dioxide is back transferred;
- metabolism: from mother to the kid proteins, fats, carbohydrates, vitamins, useful minerals arrive. Products of processing of nutrients are back removed;
- protection: there is such concept as a placentary barrier. Such barrier, a protective obstacle, the adjoining walls of maternal and fruit capillaries are. The barrier possesses selective permeability, passing the substances, necessary for the kid (oxygen, proteins, fats, sugar, vitamins) and interfering with penetration of many harmful substances and pathogenic microorganisms. The placentary barrier excludes mixing of blood of mother and kid who can differ on group and a Rhesus factor - accessories;
- production of hormones: the placenta allocates a horionichesky gonadotrophin, follikulin and progesterone, playing a huge role during pregnancy and childbirth, development of the kid.
As FPN arises?
Fetoplatsentarny insufficiency call pathology of pregnancy at which the placentary blood-groove is broken. Existence of FPN can be suspected on change of frequency and force of stirs of the kid. Sharp increase or an urezheniye of movements of a fruit and furthermore their disappearance often testifies to an unsuccessful condition of the kid, a hypoxia and placentary insufficiency.are immediate and very dangerous by
of the Consequence of this pathology to a fruit, by means of a placentary blood-groove nutrients and oxygen are delivered to the kid. At reduction of speed, mother - a placenta - a fruit the kid begins to lack for blood-groove level on any site of system the substances necessary for the normal growth and development. At it is long the existing or quickly developing FPN not only development, but also life of the kid is threatened.What reasons can lead
to violation of work so important for mother and the kid of body? Most often FPN develops against sharp and chronic diseases of mother, pathology of pregnancy or diseases of the placenta. Here the most widespread risk factors of development of FPN.
- of Ekstragenitalnye (which are not connected with gynecology) the diseases of mother. Here belongs warmly - vascular insufficiency, arterial hypertension (increase of arterial pressure), pathologies of kidneys (sharp and chronic pyelonephritis, glomerulonefrit, an urolithic illness, a renal failure), endocrine diseases (diabetes, pathology of adrenal glands, a thyroid gland, hypophysis), etc. All listed diseases influence the speed and level of a blood-groove in mother`s organism that, in turn, causes decrease in a placentary blood-groove.
- of the Disease of the sexual sphere of the pregnant woman - an endometritis (an inflammation of a mucous wall of a uterus), an inflammation of appendages, diseases, sexually transmitted (ureaplasmosis, mycoplasmosis, clamidiosis, herpes, a cytomegalovirus, etc.) . The infectious agents and their toxins getting through a placentary barrier are late placenta fabric. In places of introduction of activators inflammation ochazhka in which blood circulation, normal for a placenta, is broken are formed.
- of Pathology of pregnancy. Is the most common cause of development of placentary insufficiency in this group gestoz. One of displays of this pathology is permanent increase of arterial pressure in blood vessels that, certainly, very quickly affects the level of a placentary blood-groove. The violation of a hemostasis (the ratio of factors of the curtailing and anticurtailing system of blood providing necessary viscosity and speed of advance on vessels) which is quite often coming to light in the second and third trimester is other reason. Less often placentary insufficiency develops against the long expressed anemia of pregnant women - the disease which is characterized by decrease in level of hemoglobin in blood.
- of Pathology of a placenta. As well as any other human body, a placenta can ache too. Such disease is called platsentit and is expressed in considerable hypostasis of a placenta and violation of a placentary blood-groove. Generally the viruses capable to get through a placentary barrier are the reason of development of a platsentit. Sometimes the centers of an inflammation are limited to separate sites of a placenta; in this case in the disease outcome on the place of an inflammation petrifikata - calcification ochazhka are formed. A large number of petrifikat also complicates a placentary blood-groove.
- of Anomaly of development of a placenta. Here the hypotrophy (a “lean“ placenta), additional segments of a placenta, a partial otsloyka and the wrong attachment of a placenta belongs.
of the Reason and a consequence of FPN
because of emergence of FPN are subdivided on primary and secondary.
Primary, or early, FPN arises till 16 weeks of pregnancy when forming a placenta during implantation (an attachment to a uterus wall) under the influence of genetic, endocrine and infectious factors. At this form often occurs early (more often - early) pregnancy interruption, formation of various pathologies of development and even death of a fruit.
Secondary FPN develops after 16 weeks at the created placenta and a thicket is caused by ekstragenitalny diseases of mother, a gestozama.
On a clinical current distinguish the sharp and chronic FPN forms.
Sharp placentary insufficiency is characterized by prompt deterioration in a placentary blood-groove. At the same time there can be placenta heart attacks (death of separate sites of fabric of a placenta owing to blood supply violation), its premature otsloyka that, in turn, leads to interruption of pregnancy and death of a fruit.
Chronic placentary insufficiency develops from the second trimester, gradually increasing and causing various violations during pregnancy and development of a fruit. The most widespread consequence of chronic FPN is the chronic hypoxia (oxygen starvation) and a syndrome of an arrest of development of a fruit. In addition, at FPN permeability of a placentary barrier therefore the kid is defenseless before various damaging factors changes.
to Find and neutralize
at suspicion on FPN ultrasonography, a doppler (measurement of level of a blood-groove in vessels of a placenta, umbilical cord and uterine arteries by means of ultrasound), a kardiotokografiya (hardware measurement of heart rate and movements of a fruit within 40 - 60 minutes), analyses of urine and blood on detection of an infection, a gemostaziogramm (blood test on coagulability), etc. belongs To diagnostic testings.to
At suspicion on development of FPN future mother showed hospitalization in office of pathology of pregnant women of maternity hospital. As a rule, the pathology which led to FPN, for example the postponed sharp viral infection, gestoz, an exacerbation of a chronic urogenital infection is the reason for hospitalization (cytomega lovirus, herpes, ureaplasmosis, etc.) DVS - a syndrome (the increased viscosity of blood), and also FPN consequences - a pre-natal growth inhibition of a fruit. In a hospital conduct diagnostic testings for confirmation of the diagnosis and identification of extent of development of pathology. On the basis of the received results of researches of the pregnant woman select the therapy directed to elimination of the reason FPN and the prevention of development of complications.
At detection of a viral infection are appointed by the antiviral preparations and means strengthening immune system. Viferon, Interferon, Vilprofen, immunoglobulins belong to such means. Preparations are appointed in the form of vaginal suppositories (candles), tablets and intravenous injections at the choice of the attending physician.
At FPN which developed against a gestoz, the first stage of treatment. The most applicable drugs of this group are Atenolol and Lakren (the tableted forms).
If the increased viscosity of blood is the reason of development of FPN (DVS - a syndrome), at treatment anticoagulants - the preparations reducing viscosity of blood use. During pregnancy for this purpose appoint Fraksiparin. This medicine is entered in the form of injections (pricks) hypodermically.
For treatment of the FPN are used by the means improving rheological properties of blood and a placentary blood-groove - Aktovegin, Kurantil. The dosage and a method of introduction is selected the doctor individually taking into account the term of pregnancy and expressiveness of violation of a placentary blood-groove. These preparations are included into any scheme of treatment of FPN irrespective of the reason which caused it.carry out by
At inefficiency of treatment, considerable lag of a fruit in growth in the third trimester of pregnancy a rodorazresheniye by operation of Cesarean section after preliminary preparation.
At in due time begun treatment the forecast for the further course of pregnancy, development of the kid and childbirth will be favorable therefore you should not postpone hospitalization.